# GREAT LAKES PODIATRY ASSOCIATES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316393309
- **Authorized official:** SHELDON J GOLDSTEIN DPM (PRESIDENT)
- **Authorized official phone:** (248) 674-2575

## Contact information

- **Practice address:** 3560 PONTIAC LAKE RD, WATERFORD, MI 48328-2337
- **Practice address phone:** (248) 674-2575
- **Practice address fax:** (248) 674-0577
- **Mailing address:** 3560 PONTIAC LAKE RD, WATERFORD, MI 48328-2337
- **Mailing address phone:** (248) 674-2575
- **Mailing address fax:** (248) 674-0577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 5901000581 | MI | Yes |

## Other

- **Enumeration date:** 05/09/2016
- **Last updated:** 05/09/2016