Provider Demographics
NPI:1598794489
Name:PATOUHAS, JOYCE E (DPM)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:E
Last Name:PATOUHAS
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 1:4455 FOX HILL DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3371
Mailing Address - Country:US
Mailing Address - Phone:586-557-6170
Mailing Address - Fax:
Practice Address - Street 1:39090 GARFIELD RD STE 108
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4093
Practice Address - Country:US
Practice Address - Phone:586-286-8660
Practice Address - Fax:586-286-8353
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002231213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI2063001Medicare PIN