Organization
GREAT LAKES PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PAT LEVEILLE (PRACTICE MANAGER)
(906) 280-5396
Entity
Organization
Contact information
Practice address
126 S 25TH ST, SUITE A, ESCANABA, MI 49829-1364
(906) 786-2385
(906) 789-4445
Mailing address
126 S 25TH ST STE A, ESCANABA, MI 49829-1364
(906) 786-2385
(877) 276-3960
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4729159
—
MI
Enumeration date
06/10/2006
Last updated
03/12/2026
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