Organization
EAST SIDE FOOT & ANKLE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BERLIN D.P.M. (OWNER)
(586) 776-7000
Entity
Organization
Contact information
Practice address
22301 GREATER MACK AVE, SUITE 3, SAINT CLAIR SHORES, MI 48080-2376
(586) 776-7000
(586) 776-7003
Mailing address
22301 GREATER MACK AVE, SUITE 3, SAINT CLAIR SHORES, MI 48080-2376
(586) 776-7000
(586) 776-7003
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001005
MI
332BC3200X
Customized Equipment (DME)
5901001005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005335144
AETNA
MI
01
—
0Q24605
BLUECROSS PIN
MI
05
—
2926711
—
MI
01
—
480014028
RAILROAD MEDICARE PTAN
MI
01
—
89594B
HAP
MI
Enumeration date
03/19/2007
Last updated
09/30/2025
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