Provider Demographics
NPI:1265476824
Name:SPRIET, ANN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:SPRIET
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 E 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3790
Mailing Address - Country:US
Mailing Address - Phone:586-979-1060
Mailing Address - Fax:586-979-1714
Practice Address - Street 1:3701 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3790
Practice Address - Country:US
Practice Address - Phone:586-979-1060
Practice Address - Fax:586-979-1714
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001676213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU57867Medicare UPIN
MIOM11800002Medicare ID - Type Unspecified