Provider Demographics
NPI:1790880284
Name:POPOFSKI, AIMEE ANTOINETTE (DPM)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:ANTOINETTE
Last Name:POPOFSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:ANTOINETTE
Other - Last Name:BOYETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:9640 COMMERCE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4166
Mailing Address - Country:US
Mailing Address - Phone:248-360-3888
Mailing Address - Fax:248-363-0894
Practice Address - Street 1:29433 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2203
Practice Address - Country:US
Practice Address - Phone:865-574-0500
Practice Address - Fax:586-574-2694
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002236213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4931873Medicaid
MI5631521OtherBCBS OF MICHIGAN
P00921459OtherRAILROAD MEDICARE
MI4931873Medicaid
P00921459OtherRAILROAD MEDICARE