Provider Demographics
NPI:1508944539
Name:FRANKLIN PARK PODIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:FRANKLIN PARK PODIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:SALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-352-5920
Mailing Address - Street 1:32255 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1566
Mailing Address - Country:US
Mailing Address - Phone:248-352-5920
Mailing Address - Fax:248-352-6388
Practice Address - Street 1:32255 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1566
Practice Address - Country:US
Practice Address - Phone:248-352-5920
Practice Address - Fax:248-352-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1325234Medicaid
MI0525370001Medicare NSC
MI0F36279Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER