Organization
SPECIALIZED PODIATRY SERVICES P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC WEINER DPM (PRESIDENT)
24893226078
Entity
Organization
Contact information
Practice address
2035 WICKFORD CT, BLOOMFIELD HILLS, MI 48304-1088
(248) 932-2607
Mailing address
2035 WICKFORD CT, BLOOMFIELD HILLS, MI 48304-1088
(248) 932-2607
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MW000841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MW000841
STATE LICENSE
MI
Enumeration date
05/26/2007
Last updated
06/22/2012
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