Provider Demographics
NPI:1013043363
Name:G M FELHANDLER DPM PC
Entity Type:Organization
Organization Name:G M FELHANDLER DPM PC
Other - Org Name:MONROE COUNTY PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:FELHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:734-243-5888
Mailing Address - Street 1:1092 N MONROE STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162
Mailing Address - Country:US
Mailing Address - Phone:734-243-5888
Mailing Address - Fax:734-243-6166
Practice Address - Street 1:1092 N MONROE STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162
Practice Address - Country:US
Practice Address - Phone:734-243-5888
Practice Address - Fax:734-243-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001038213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1443514Medicaid
T34133Medicare UPIN
MI1443514Medicaid