ANDREW RICHARD MASTAY (NPI# 1093120297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093120297 |
| Entity Type | Individual |
| Full Name | ANDREW RICHARD MASTAY |
| Credential | DPM |
| Practice Address |
20905 E 12 Mile Rd Ste 100 Roseville MI 48066-6501 |
| Practice Telephone | 5867723500 |
| Practice Fax Number | 5867726540 |
| Mailing Telephone | 5867723500 |
| Mailing Fax Number | 5867726540 |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2019-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
AM002523 | MI | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5901002523 | MI | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15855 19 Mile Rd, Clinton Twp, MI 480383504 | 5862632951 |
| Street Address |
20905 E 12 MILE RD STE 100 |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194854737 | Steven K. Shoemaker, Dpm and Associates, Inc. | Podiatrist | 1421 Secret Ravine Pkwy Ste 111, Roseville, CA 95661-6045 | 2007-03-02 |
| 1194890954 | Michael Joyce | Podiatrist | 2680 Snelling Ave No, Suite 260, Roseville, MN 55113-1821 | 2006-11-21 |
| 1477633899 | Advanced Foot & Ankle Center PC | Podiatrist | 25990 Kelly, Suite 4, Roseville, MI 48066 | 2006-10-17 |
| 1962459545 | Edward Law | Podiatrist | 151 N Sunrise Ave Ste 1409, Roseville, CA 95661-2934 | 2006-05-28 |
| 1669454013 | Michelle M Deyoung | Podiatrist | 20905 E 12 Mile Rd, Ste 100, Roseville, MI 48066-6501 | 2005-11-18 |
| 1215393715 | Benjamin Van Pham | Podiatrist | 1650 Lead Hill Blvd Ste 100, Roseville, CA 95661-3072 | 2016-01-13 |
| 1184965725 | Mark Drake | Podiatrist | 5 Medical Plaza Dr, 110, Roseville, CA 95661-2865 | 2013-03-06 |
| 1356509590 | Michael Joyce Dpm Pa | Podiatrist | 2680 Snelling Ave No, Suite 260, Roseville, MN 55113-1821 | 2008-05-23 |
| 1730350901 | Victor R Suckesi Dpm | Podiatrist | 729 Sunrise Ave, Suite 607, Roseville, CA 95661 | 2008-03-17 |
| 1841476397 | Steven K Shoemaker | Podiatrist | 1421 Secret Ravine Pkwy, Suite 111, Roseville, CA 95661-6045 | 2008-01-15 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.