Organization
FOOT AND ANKLE CLINIC OF WEST MICHIGAN,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN L MAST DPM (OWNER)
(231) 843-2690
Entity
Organization
Contact information
Practice address
333 N JEBAVY DR, LUDINGTON, MI 49431-1923
(231) 843-2690
(231) 843-4338
Mailing address
333 N JEBAVY DR, LUDINGTON, MI 49431-1923
(231) 843-2690
(231) 843-4338
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001496
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E36017
MEDICARE ID-TYPE UNSPECIF
MI
05
—
2584722
—
MI
Enumeration date
09/25/2006
Last updated
07/24/2008
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