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Organization
LAWRENCE M FALLAT DPM PC
Active
Organization
LAWRENCE M FALLAT DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE MICHAEL FALLAT DPM (PRESIDENT)
(313) 389-2288
Entity
Organization
Contact information
Practice address
20555 ECORSE RD, TAYLOR, MI 48180-1992
(313) 389-2288
(313) 389-2286
Mailing address
20555 ECORSE RD, TAYLOR, MI 48180-1992
(313) 389-2288
(313) 389-2286
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
LF000848
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H27018
BCBS PIN
MI
05
—
131352563
—
MI
Enumeration date
10/24/2006
Last updated
05/13/2009
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