Organization
GREAT LAKES PODIATRY PLLC
Active
Organization
GREAT LAKES PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS W LEVEILLE DPM (OWNER/PODIATRIST)
(906) 786-2385
Entity
Organization
Contact information
Practice address
126 S 25TH ST STE A, ESCANABA, MI 49829-1364
(906) 786-2385
(877) 276-3960
Mailing address
W4042 LAKE MARY DR S, VULCAN, MI 49892-8452
(906) 280-5396
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5901001228
MI
335E00000X
Prosthetic/Orthotic Supplier
5901001228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225079932
—
MI
05
—
1982696209
—
MI
Enumeration date
01/18/2018
Last updated
03/12/2026
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