Organization
GFC OF SOUTHEASTERN MICHIGAN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANISHA MEHTA DPM (PHYSICIAN)
(313) 833-3090
Entity
Organization
Contact information
Practice address
4160 JOHN R ST STE 1011, DETROIT, MI 48201-2017
(313) 833-3090
(313) 833-7843
Mailing address
4160 JOHN R ST STE 111, DETROIT, MI 48201-2021
(313) 833-3090
(313) 833-7843
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002275
MI
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316191679
MEDICARE NPI
MI
05
—
1417136029
—
MI
01
—
82028141
PROCARE
MI
Enumeration date
11/12/2008
Last updated
12/04/2025
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