Organization
DIABETIC FOOT PLLC
Active
Other names
Diabetic Foot Management Center of MI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN ELAINE HOLIBAUGH DPM (PRESIDENT)
(231) 733-1511
Entity
Organization
Contact information
Practice address
1281 E SHERMAN BLVD, MUSKEGON, MI 49444-1846
(231) 733-1511
(231) 733-7980
Mailing address
1281 E SHERMAN BLVD, PO BOX 4344, MUSKEGON, MI 49444-1846
(231) 733-1511
(231) 733-7980
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SH001528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235107632
NPI TYPE I
—
05
—
2693057
—
MI
Enumeration date
08/13/2007
Last updated
08/13/2007
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