Michigans Premier Foot and Ankle PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

MICHIGANS PREMIER FOOT AND ANKLE PLLC

Practice address

17000 Executive Plaza Dr Ste 101
Dearborn, MI 48126-2793

Phone

(313) 565-4948

Fax

(313) 565-4989

NPI assigned

Oct 21, 2019

Organization subpart

No

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

Authorized official

Name

Alaa Mansour, DPM

Title

Sole Member

Phone

(630) 808-9939

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1962045161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5861 DEEPWOOD CT",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 EXECUTIVE PLAZA DR STE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262793",
            "telephone_number": "313-565-4948",
            "fax_number": "313-565-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGANS PREMIER FOOT AND ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "ALAA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "630-808-9939",
        "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": []
}

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• All providers in Dearborn, MI
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.