Organization
MICHIGAN FOOT SURGEONS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARNIE LOUISE HARRIS (OFFICE MANAGER)
(248) 355-4000
Entity
Organization
Contact information
Practice address
12720 W 7 MILE RD, DETROIT, MI 48235-1301
(313) 863-6888
(313) 863-1687
Mailing address
12720 W 7 MILE RD, DETROIT, MI 48235-1301
(313) 863-6888
(313) 863-1687
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
FL000635
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
RL002077
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1084800
—
MI
01
—
1528091378
FRED NPI
—
01
—
1669497327
RANDY NPI
—
Enumeration date
08/06/2007
Last updated
08/22/2020
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