Individual
SIRAJ PANCHBHAIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
11900 E 12 MILE RD STE 102, WARREN, MI 48093-3487
(586) 573-7470
(586) 573-0850
Mailing address
20176 LIVERNOIS AVE 100, DETROIT, MI 48221-1346
(313) 864-7385
(313) 864-7384
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002488
MI
Other
Enumeration date
06/18/2013
Last updated
08/12/2015
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