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Organization
DIABETIC FOOT PLLC
Active
Organization
DIABETIC FOOT PLLC
Active
Other names
Diabetic Foot Management Center of MI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN ELAINE HOLIBAUGH DPM (PRESIDENT)
(231) 733-1511
Entity
Organization
Contact information
Practice address
1281 E SHERMAN BLVD, MUSKEGON, MI 49444-1846
(231) 733-1511
(231) 733-7980
Mailing address
1281 E SHERMAN BLVD, PO BOX 4344, MUSKEGON, MI 49444-1846
(231) 733-1511
(231) 733-7980
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SH001528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235107632
NPI TYPE I
—
05
—
2693057
—
MI
Enumeration date
08/13/2007
Last updated
08/13/2007
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