Provider Demographics
NPI:1164855490
Name:ROBERT G PATRUS DPM PC
Entity Type:Organization
Organization Name:ROBERT G PATRUS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRUS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:586-775-1910
Mailing Address - Street 1:26020 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3773
Mailing Address - Country:US
Mailing Address - Phone:586-775-1910
Mailing Address - Fax:586-775-8387
Practice Address - Street 1:26020 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3773
Practice Address - Country:US
Practice Address - Phone:586-775-1910
Practice Address - Fax:586-775-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric