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Organization

SHORELINE FOOT & ANKLE ASSOCIATES P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROGER DEYOUNG D.P.M. (OWNER)
(231) 733-1111
Entity
Organization

Contact information

Practice address
561 SEMINOLE RD, NORTON SHORES, MI 49444-3719
(231) 733-1111
(231) 733-1144
Mailing address
561 SEMINOLE RD, MUSKEGON, MI 49444-3719
(231) 733-1111
(231) 733-1144

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2759945
MI
05
3524970
MI
05
4337945
MI
Enumeration date
02/13/2007
Last updated
01/24/2022
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