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Organization
LAKESIDE FOOT AND LEG CARE PLLC
Active
Organization
LAKESIDE FOOT AND LEG CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIRAJ PANCHBHAIYA DPM (OWNER)
(248) 739-1379
Entity
Organization
Contact information
Practice address
14322 GRANDVIEW DR, STERLING HEIGHTS, MI 48313-3447
(248) 739-1379
Mailing address
14322 GRANDVIEW DR, STERLING HEIGHTS, MI 48313-3447
(248) 739-1379
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
01/23/2023
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