Organization
HYGAIT PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M HYDE D.P.M. (PRESIDENT)
(616) 822-2007
Entity
Organization
Contact information
Practice address
2155 VAN DYKE ST, CONKLIN, MI 49403-9598
(616) 822-2007
(616) 899-5358
Mailing address
PO BOX 157, SPARTA, MI 49345-0157
(616) 822-2007
(616) 899-5358
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001927
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4854110970
BLUECROSSBLUE SHIELD MI
MI
Enumeration date
07/26/2006
Last updated
08/22/2020
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