Organization
DEARBORN PODIATRIC SURGEONS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE A. YOUNG D.P.M. (DOCTOR)
(313) 565-8080
Entity
Organization
Contact information
Practice address
22161 OUTER DR, DEARBORN, MI 48124-3901
(313) 565-8080
(313) 565-2417
Mailing address
22161 W. OUTER DRIVE, DEARBORN, MI 48124-3901
(313) 565-8080
(313) 565-2417
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901000652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1062616
—
MI
01
—
112003
CARE CHOICES
MI
01
—
5825276
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/17/2007
Last updated
08/22/2020
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