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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5901002021 | MI | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 4476009 | 05 |
Street Address |
24025 GREATER MACK SUITE 101 |
City | SAINT CLAIR SHORES |
State | MI |
Zip Code | 48080 |
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 |
Find all providers in zip 48080 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
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 |
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 |
Find all providers with the same taxonomy |
City | SAINT CLAIR SHORES |
Zip Code | 48080 |
Please comment or provide details below to improve the information on EASTSIDE PODIATRY PLLC.
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.