Associated Foot Clinic of Fenton, P.C.

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

NPI 1962570853 · NPPES record last updated Oct 6, 2009

Key facts

NPI
1962570853
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
JN001106 (MI)
Legal business name
ASSOCIATED FOOT CLINIC OF FENTON, P.C.
Practice address
102 N Adelaide St
Fenton, MI 48430-2670
Phone
(810) 750-8300
NPI assigned
Dec 1, 2006
Organization subpart
No

Authorized official

Name
Dr. Jeffrey C Noroyan, D.P.M.
Title
Owner
Phone
(810) 750-8300

Practitioners 3

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
O20070125000022 MI Part B Supplier - Clinic/Group Practice 1456352046 Receives reassigned benefits from 2 practitioners
Practice locations: Fenton, MI
O20100930007619 MI DME Supplier - Physician - Podiatry 1456352046 Practice locations: Fenton, MI

National Provider Directory

Locations

915 S Dort Hwy
Flint, MI 48503
Phone (810) 233-5950

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X JN001106 MI Yes

Addresses

Primary practice location

102 N Adelaide St
Fenton, MI 48430-2670

Mailing address

191 N Park Blvd
Lake Orion, MI 48362
Phone (810) 693-8400

Other identifiers

IdentifierTypeStateIssuer
48-0B514890OtherMIBCBSM

Other providers in Fenton, MI

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

Sources for this page

Verify at the official NPI Registry.