EASTSIDE PODIATRY PLLC


Address: 24025 Greater Mack, Suite 101, Saint Clair Shores, MI 48080
Phone: 3138847566

EASTSIDE PODIATRY PLLC (NPI# 1144377821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144377821
Entity Type Organization
Organization Name EASTSIDE PODIATRY PLLC
Practice Address 24025 Greater Mack
Suite 101
Saint Clair Shores
MI 48080
Mailing Address 24025 Greater Mack
Suite 101
St. Clair Shores
MI 48080-4311
Practice Telephone 3138847566
Practice Fax Number 3138843140
Mailing Telephone 3138847566
Mailing Fax Number 3138843140
Enumeration Date 2007-01-04
Last Update Date 2018-05-22
Authorized Official Name HATIM TAHIR BURHANI (OWNER)
Authorized Official Telephone 3138847566
Authorized Official Credential DPM
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
5901002021 MI Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI 4476009 05

Office Location

Street Address 24025 GREATER MACK
SUITE 101
City SAINT CLAIR SHORES
State MI
Zip Code 48080

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508482084 Farrah Aleema Rajab Family Medicine 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 2020-06-22
1558986141 Julia Anastazja Krakowska Family Medicine 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 2020-06-10
1972073567 Joyce Stepnak Social Worker 19611 E. 8 Mile Rd, Scs, MI 48080 2018-11-27
1487134177 Bonnie Girson Social Worker 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 2018-08-21
1609309913 Park Pharmacy Scs LLC Pharmacy 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 2017-04-05
1730564055 Mary Rose Giroux Psychologist 22516 Overlake St, St. Clair Shores, MI 48080 2015-07-28
1962882910 Ali Tarif Bazzy Family Medicine 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 2015-06-04
1497156228 Kelly Zalewski Social Worker 24631 Jefferson Ave, Saint Clair Shores, MI 48080 2014-09-11
1669871364 Mallory Margret Gordon Psychologist 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 2014-08-19
1932549375 Alexander Peter Bill Otolaryngology 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 2013-06-30
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Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750602108 Christopher Alan Larson Podiatrist 27593 Harper Ave, Saint Clair Shores, MI 48081-1923 2010-06-21
1730204181 Raymond J Farrar Podiatrist 29840 Harper Ave, Saint Clair Shores, MI 48082-2608 2007-03-21
1851382972 Larry N Magid Podiatrist 27609 Little Mack Ave, Saint Clair Shores, MI 48081-1833 2005-10-31
1194141010 Scott Homer Podiatrist 27609 Little Mack Ave, Saint Clair Shores, MI 48081 2014-03-17
1780771949 Larry N. Magid, Dpm PC Podiatrist 27609 Little Mack Ave, Saint Clair Shores, MI 48081-1833 2006-10-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1366056665 Radu Purtuc Dpm Pllc Podiatrist 20005 Hidden Oaks Dr, Brownstown, MI 48183-3276 2020-09-03
1790300978 Bhavik Patel Podiatrist 16001 W 9 Mile Rd Fl 2, Southfield, MI 48075-4818 2020-06-12
1265056410 Husein Yusuf Husein Podiatrist Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 2020-06-03
1770104580 Ali Chami Podiatrist 20115 River Oaks Dr, Dearborn Heights, MI 48127-2709 2020-05-04
1780233627 Bloomfield Foot & Ankle Specialists Pllc Podiatrist 43750 Woodward Ave Ste 102, Bloomfield Hills, MI 48302-5063 2019-09-04
1063068435 Monaghan Post-vasold Podiatry Plc Podiatrist 5377 N Waldo Rd, Midland, MI 48642-9713 2019-08-12
1598323909 Lakeside Foot & Leg Care Pllc Podiatrist 14322 Grandview Dr, Sterling Heights, MI 48313-3447 2019-05-31
1285297481 J Weber Medical Group Pllc Podiatrist 620 Woodmere Ave Ste C, Traverse City, MI 49686-3397 2019-04-15
1093219743 Holland Community Hospital Podiatrist 3299 N Wellness Dr Ste 230, Holland, MI 49424-7271 2018-03-19
1780182907 Jeffrey Schwalb Dpm Pllc Podiatrist 5755 W Maple Rd Ste 115, W Bloomfield, MI 48322-4415 2018-01-23
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Competitor

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City SAINT CLAIR SHORES
Zip Code 48080

Improve Information

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Dataset Information

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.

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