DR. GUY RICHARD PUPP (NPI# 1467428045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467428045 |
| Entity Type | Individual |
| Full Name | DR. GUY RICHARD PUPP |
| Credential | DPM |
| Practice Address |
22250 Providence Dr Ste 100 Southfield MI 48075-6209 |
| Practice Telephone | 2484248637 |
| Practice Fax Number | 2484248663 |
| Mailing Telephone | 2484248637 |
| Mailing Fax Number | 2484248663 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2018-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
GP000690 | MI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4275305 | 05 | |
| MI | DME SUPPLIER # | 479116001 | 01 |
| MI | BCBS | OH 27788 | 01 |
| MI | HAP PROVIDER # | T34213 | 01 |
| Street Address |
22250 PROVIDENCE DR STE 100 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-6209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821512930 | Foot & Ankle Institute of Michigan Pllc | Podiatrist | 22250 Providence Dr Ste 100, Southfield, MI 48075-6209 | 2017-07-31 |
| 1306371588 | Joshua Kazdan | Podiatrist | 22250 Providence Dr Ste 100, Southfield, MI 48075-6209 | 2017-04-26 |
| 1518992536 | Lakeview Podiatry Assoc P C | Podiatrist | 22250 Providence Dr Ste 100, Southfield, MI 48075-6209 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 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 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790300978 | Bhavik Patel | Podiatrist | 16001 W 9 Mile Rd Fl 2, Southfield, MI 48075-4818 | 2020-06-12 |
| 1538249982 | Nsima Usen Dpm, Mph, P.c | Podiatrist | 27177 Lahser Rd Ste 200, Southfield, MI 48034-8468 | 2006-10-17 |
| 1679510937 | Nsima Usen Dpm, Mph, PC | Podiatrist | 20903 Greenfield Road, Suite 503, Southfield, MI 48075 | 2006-06-02 |
| 1518963628 | Bruce Ian Kaczander | Podiatrist | 24725 W 12 Mile Rd, Ste 270, Southfield, MI 48034-8310 | 2005-06-23 |
| 1629631965 | Rachelle Lynn Leveille | Podiatrist | 16001 W. 9 Mile Road, 2nd Floor Depaul, Southfield, MI 48075-4818 | 2019-04-22 |
| 1083160329 | Rashonda Jones | Podiatrist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2016-08-28 |
| 1255708574 | Dr. Tameka Parham Taylor, Pllc | Podiatrist | 29425 Northwestern Hwy Ste 125, Southfield, MI 48034-1083 | 2015-08-24 |
| 1144604463 | Vangjo Cobani | Podiatrist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2015-07-16 |
| 1598149379 | Ahmad Talal Elhaouli | Podiatrist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2015-07-12 |
| 1386022499 | Mohomad Al Sawah | Podiatrist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2015-05-08 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on DR. GUY RICHARD PUPP.
| 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.