Organization
SPARTAN PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA ROBIN DPM (VICE PRESIDENT)
(269) 781-4700
Entity
Organization
Contact information
Practice address
1600 SOUTH KALAMAZOO AVE., MARSHALL, MI 49068
(269) 781-4700
(269) 781-7168
Mailing address
1600 SOUTH KALAMAZOO AVE., MARSHALL, MI 49068
(269) 781-4700
(269) 781-7168
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
WG000970
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211332613
—
MI
01
—
485135002
BCBS DR. JAMES GRAY
MI
01
—
485135003
BCBS DR. WILLIAM GRAY
MI
Enumeration date
05/04/2007
Last updated
04/13/2023
Update your record
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