Provider Demographics
NPI:1144422916
Name:MICHIGAN FOOT & ANKLE SPECIALISTS
Entity Type:Organization
Organization Name:MICHIGAN FOOT & ANKLE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAFIEDINE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:313-582-6222
Mailing Address - Street 1:7243 CHASE RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1301
Mailing Address - Country:US
Mailing Address - Phone:313-582-6222
Mailing Address - Fax:313-582-0166
Practice Address - Street 1:7243 CHASE RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1301
Practice Address - Country:US
Practice Address - Phone:313-582-6222
Practice Address - Fax:313-582-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI59010021116213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N83370Medicare PIN
MI5032980001Medicare NSC