Organization
G. DANIEL SHANAHAN IV DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE DANIEL SHANAHAN IV DPM (OWNER)
(248) 360-3888
Entity
Organization
Contact information
Practice address
9640 COMMERCE RD STE 102, COMMERCE TWP, MI 48382-4167
(248) 360-3888
(248) 363-0894
Mailing address
9640 COMMERCE RD STE 102, COMMERCE TWP, MI 48382-4167
(248) 360-3888
(248) 363-0894
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003818907
G. D SHANAHAN DPM NPI #
—
01
—
1770712358
JENNIFER L PETRONELLA DPM NPI NUMBER
—
01
—
1790880284
AIMEE A. POPOFSKI DPM NPI NUMBER
—
01
—
480F321940
BLUE CROSS BLUE SHIELD
MI
01
—
5901001605
G DANIEL SHANAHAN IV DPM STATE LICENSE
MI
01
—
5901002236
AIMEE A. POPOFSKI STATE LICENSE
MI
01
—
5901002333
JENNIFER L PETRONELLA DPM STATE LICENSE
MI
01
—
N78970
MEDICARE GROUP NUMBER
—
Enumeration date
09/16/2006
Last updated
03/19/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us