Organization
MICHIGAN FOOT & ANKLE SURGEONS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARNIE LOUISE HARRIS (OFFICE MANAGER)
(248) 355-4000
Entity
Organization
Contact information
Practice address
29201 TELEGRAPH RD, SUITE 100, SOUTHFIELD, MI 48034-1331
(248) 355-4000
(248) 355-4047
Mailing address
29201 TELEGRAPH RD, SUITE 100, SOUTHFIELD, MI 48034-1331
(248) 355-4000
(248) 355-4047
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
FL000635
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
RL002077
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528091378
FRED NPI
—
01
—
1669497327
RANDY NPI
—
05
—
4741574
—
MI
Enumeration date
06/29/2007
Last updated
12/11/2008
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