Organization Active NPI

Dearborn Podiatry Clinic PLLC

  • Foot & Ankle Surgery Podiatrist
  • Detroit, MI
National Provider Identifier
1912383928
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
DEARBORN PODIATRY CLINIC PLLC
Practice address
7633 E Jefferson Ave
Suite 250
Detroit, MI 48214-3730
Phone
(313) 821-3338
Fax
(313) 823-5363
NPI assigned
Aug 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Authorized official

Name
Amer El-Khatib, DPM
Title
Owner
Phone
(313) 443-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

7633 E Jefferson Ave
Suite 250
Detroit, MI 48214-3730

Mailing address

7633 E Jefferson Ave
Suite 250
Detroit, MI 48214-3730
Phone (313) 821-3338

National Provider Directory

National Provider Directory

Locations

7633 E Jefferson Ave
Ste 2
Detroit, MI 48214
Phone (313) 821-3338

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1912383928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE",
            "address_2": "SUITE 250",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143730",
            "telephone_number": "313-821-3338",
            "fax_number": "313-823-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE",
            "address_2": "SUITE 250",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143730",
            "telephone_number": "313-821-3338",
            "fax_number": "313-823-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN PODIATRY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "EL-KHATIB",
        "authorized_official_first_name": "AMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-443-7770",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.