Organization
SCOTT T GRODMAN DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT T GRODMAN DPM (OWNER)
(248) 547-2450
Entity
Organization
Contact information
Practice address
3055 HILTON RD, SUITE C, FERNDALE, MI 48220-1096
(248) 547-2450
Mailing address
3055 HILTON RD, SUITE C, FERNDALE, MI 48220-1096
(248) 547-2450
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
001478
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2948227
—
MI
01
—
4858213180
BCBS
MI
01
—
540H227900
BC DME
MI
Enumeration date
05/30/2007
Last updated
07/15/2008
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