Lakeview Podiatry Assoc P C

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901000690 Issued in MI

Legal business name

LAKEVIEW PODIATRY ASSOC P C

Practice address

22250 Providence Dr Ste 100
Southfield, MI 48075-6209

Phone

(248) 424-8637

Fax

(248) 424-8663

NPI assigned

Jul 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Guy Pupp, DPM

Title

Physician

Phone

(248) 424-8637

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1518992536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756209",
            "telephone_number": "248-424-8637",
            "fax_number": "248-424-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756209",
            "telephone_number": "248-424-8637",
            "fax_number": "248-424-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW PODIATRY ASSOC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "PUPP",
        "authorized_official_first_name": "GUY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "248-424-8637",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0M07610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0H2788",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4275305",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP PROVIDER #",
            "identifier": "T34213",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lakeside Transport Group, Inc
• Lakeview Family Dental - Southfield, PLLC
• Lakewood Medical Center Inc
• Mark Stanley Lakier, MSW
• Kalaiselvi Lakshmanan, OCCUPATIONAL THERAPY
• Daniel Thomas Wilson Lalonde, M.D.
• Noelle Lalonde

• Foot & Ankle Surgery Podiatrist in Southfield, MI
• Providers in Southfield, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.