Organization
LAKESIDE FOOT AND LEG CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIRAJ PANCHBHAIYA DPM (OWNER)
(248) 739-1379
Entity
Organization
Contact information
Practice address
14322 GRANDVIEW DR, STERLING HEIGHTS, MI 48313-3447
(248) 739-1379
Mailing address
14322 GRANDVIEW DR, STERLING HEIGHTS, MI 48313-3447
(248) 739-1379
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
01/23/2023
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