Ankle & Foot Clinic PC

Organization Active NPI Foot & Ankle Surgery Podiatrist · Eastpointe, MI

NPI 1770511784 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1770511784
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
5901001883 (MI)
Legal business name
ANKLE & FOOT CLINIC PC
Practice address
23700 Gratiot Ave
Eastpointe, MI 48021-1647
Phone
(586) 779-1160
Fax
(586) 779-1163
NPI assigned
Jun 29, 2006
Organization subpart
No

Authorized official

Name
Syed M Ghani, DPM
Title
President
Phone
(586) 779-1160

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041026001129 MI Part B Supplier - Clinic/Group Practice 3375504954 Receives reassigned benefits from 1 practitioner
Practice locations: Eastpointe, MI
O20100930047411 MI DME Supplier - Physician - Podiatry 3375504954 Practice locations: Eastpointe, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X 5901001883 MI Yes

Addresses

Primary practice location

23700 Gratiot Ave
Eastpointe, MI 48021-1647

Mailing address

23700 Gratiot Ave
Eastpointe, MI 48021-1647
Phone (586) 779-1160

Other names

  • NONE Doing business as

Other providers in Eastpointe, MI

All providers in Eastpointe, MI · Foot & Ankle Surgery Podiatrist in Michigan

Sources for this page

Verify at the official NPI Registry.