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Organization
LONG LAKE PODIATRY PC
Active
Organization
LONG LAKE PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID H BERLIN DPM (OWNER/DOCTOR)
(248) 528-0709
Entity
Organization
Contact information
Practice address
2914 E LONG LAKE RD, TROY, MI 48085-3780
(248) 528-0709
(248) 528-1807
Mailing address
2914 E LONG LAKE RD, TROY, MI 48085-3780
(248) 528-0709
(248) 528-1807
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
5901001005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005335144
AETNA
MI
05
—
1634294
—
MI
01
—
5631470
BCROSS PIN
MI
01
—
89594B
HAP
MI
01
—
NC025717
PPOM PROVIDER CODE
MI
01
—
P00245692
RAILROAD MEDICARE PTAN
MI
Enumeration date
12/31/2007
Last updated
09/30/2025
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