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Organization

NORTHWEST PODIATRY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN SCHRAM DPM (VICE PRESIDENT)
(248) 626-7180
Entity
Organization

Contact information

Practice address
5755 W MAPLE RD, STE 115, WEST BLOOMFIELD, MI 48322-4415
(248) 626-7180
(248) 626-7175
Mailing address
5755 W MAPLE RD, STE 115, WEST BLOOMFIELD, MI 48322-4415
(248) 626-7180
(248) 626-7175

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480F371150
BLUE CROSS BLUE SHIELD
MI
01
AS400226
LICENSE
MI
01
HR001598
LICENSE
MI
01
LH000829
LICENSE
MI
Enumeration date
08/31/2006
Last updated
10/28/2010
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