Organization
MERCER ISLAND FOOT AND ANKLE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAK S ABULHOSN DPM (PODIATRIST)
(206) 275-9117
Entity
Organization
Contact information
Practice address
3236 78TH AVENUE SE, #201, MERCER ISLAND, WA 98040
(206) 275-9117
(206) 275-3693
Mailing address
3236 78TH AVENUE SE, #201, MERCER ISLAND, WA 98040
(206) 275-9117
(206) 275-3693
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO730
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3488AB
REGENCE BCBS
WA
05
—
7130693
—
WA
01
—
DG4542
RAILROAD MEDICARE
WA
Enumeration date
11/06/2006
Last updated
06/16/2008
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