Organization
HPFC INC
Active
Other names
Highland Park Foot Clinic Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD EUGENE WILSON D.P.M. (PODIATRIST)
(313) 865-4400
Entity
Organization
Contact information
Practice address
18460 REVERE ST, DETROIT, MI 48234-1726
(313) 865-4400
(313) 865-4400
Mailing address
18460 REVERE ST, DETROIT, MI 48234-1726
(313) 865-4400
(313) 865-4400
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
5901001377
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131753526
—
MI
01
—
480H231720
BCBS PIN
MI
Enumeration date
05/25/2007
Last updated
02/26/2010
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