Organization
FEET FIRST P C
Active
Parent organization
FEET FIRST PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FEET FIRST PC
Authorized official
ELLEN MADY (PRESIDENT)
(248) 624-8338
Entity
Organization
Contact information
Practice address
2300 HAGGERTY RD, S-1175, WEST BLOOMFIELD, MI 48323-2184
(248) 624-8338
(248) 926-9498
Mailing address
2300 HAGGERTY RD, S-1175, WEST BLOOMFIELD, MI 48323-2184
(248) 624-8338
(248) 926-9498
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480F318320
BLUE CROSS BLUE SHIELD
MI
01
—
5357612
AETNA
MI
Enumeration date
11/30/2006
Last updated
07/14/2010
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