Organization
BRIAN G. LODER DPM PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GEORGE LODER DPM (OWNER)
(586) 329-3895
Entity
Organization
Contact information
Practice address
43391 COMMONS DR, CLINTON TWP, MI 48038-1109
(586) 329-3895
(586) 329-3916
Mailing address
15760 19 MILE RD STE E, CLINTON TWP, MI 48038-6319
(586) 329-3895
(586) 329-3916
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001662
MI
332B00000X
Durable Medical Equipment & Medical Supplies
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508004920
—
MI
01
—
480E027990
BCBS GROUP
MI
01
—
DP6530
RAILROAD MEDICARE
MI
01
—
U53759
HAP
MI
Enumeration date
01/22/2009
Last updated
11/02/2022
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