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Organization
THOMAS DEKORTE
Active
Organization
THOMAS DEKORTE
Active
Other names
Charlevoix Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS B DEKORTE DPM (PRESIDENT)
(231) 547-4662
Entity
Organization
Contact information
Practice address
1404 BRIDGE ST, CHARLEVOIX, MI 49720-2603
(231) 547-4662
Mailing address
1773 WOODSIDE TRL NW, GRAND RAPIDS, MI 49504-2580
(616) 453-1835
(616) 453-1725
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TD001078
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441583
—
MI
01
—
4851550000
BCBSM
MI
Enumeration date
12/31/2007
Last updated
12/31/2007
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