# LAKEVIEW PODIATRY ASSOC P C

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

## Provider details

- **NPI number:** 1518992536
- **Authorized official:** GUY PUPP DPM (PHYSICIAN)
- **Authorized official phone:** (248) 424-8637

## Contact information

- **Practice address:** 22250 PROVIDENCE DR STE 100, SOUTHFIELD, MI 48075-6209
- **Practice address phone:** (248) 424-8637
- **Practice address fax:** (248) 424-8663
- **Mailing address:** 22250 PROVIDENCE DR STE 100, SOUTHFIELD, MI 48075-6209
- **Mailing address phone:** (248) 424-8637
- **Mailing address fax:** (248) 424-8663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 5901000690 | MI | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 10/17/2017