GFC OF SOUTHEASTERN MICHIGAN PC NPI 1316191679

NPI Information

GFC OF SOUTHEASTERN MICHIGAN, PC is a foot and ankle surgery podiatrist in Detroit, MI. GFC OF SOUTHEASTERN MICHIGAN, PC NPI is 1316191679. The provider is registered as an organization entity type.

The provider's business location address is:

15 E KIRBY ST
SUITE 102
DETROIT, MI
ZIP 48202-047
Phone: (313) 833-3090
Fax: (313) 833-7843

The provider's authorized official is Manisha Mehta .
The authorized official title is Physician and has the following contact phone number (313) 833-3090.

The CLIA number assigned to this NPI record is 23D2199088 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/12/2008 and was last updated on 1/3/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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