Organization
FOOT AND ANKLE SPECIALTY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUMMER TOURFA (OFFICE MANAGER)
(313) 846-9717
Entity
Organization
Contact information
Practice address
5525 SCHAEFER RD, DEARBORN, MI 48126-3253
(313) 846-9717
(313) 846-9805
Mailing address
5525 SCHAEFER RD, DEARBORN, MI 48126-3253
(313) 846-9717
(313) 846-9805
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002122
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4849095
—
MI
01
—
4858213650
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/25/2007
Last updated
03/22/2013
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