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Organization
PODIATRY EXAMINERS OF MICHIGAN PC
Active
Organization
PODIATRY EXAMINERS OF MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG MARSHALL GASTWIRTH DPM (PRESIDENT)
(313) 833-3090
Entity
Organization
Contact information
Practice address
3800 WOODWARD AVENUE, SUITE 318, DETROIT, MI 48201-2066
(313) 833-3096
(313) 833-7843
Mailing address
3800 WOODWARD AVENUE, SUITE 318, DETROIT, MI 48201-2066
(313) 833-3096
(313) 833-7843
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0814
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002631
MIDWEST HEALTH PLAN
—
01
—
0961720001
DMERC
MI
01
—
123985
WELLNESS PLAN
—
05
—
1260775
—
MI
01
—
15982
CAPE HEALTH PLAN
—
01
—
20094
OMICARE HEALTH PLAN
—
01
—
4888250510
BLUE CROSS
MI
01
—
P00248
HUMANA CHOICE CARE
—
01
—
U23902
HEALTH ALLIANCE PLAN
—
Enumeration date
08/17/2006
Last updated
04/20/2008
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