Provider Demographics
NPI:1851346555
Name:SAPERSTEIN, HARVEY S (DPM)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:S
Last Name:SAPERSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11477 EAST 12 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2678
Mailing Address - Country:US
Mailing Address - Phone:586-751-0200
Mailing Address - Fax:586-751-0414
Practice Address - Street 1:11477 EAST 12 MILE ROAD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2678
Practice Address - Country:US
Practice Address - Phone:586-751-0200
Practice Address - Fax:586-751-0414
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000468213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
480E011170OtherBCBSM
MI445891Medicaid
MI445891Medicaid
T34372Medicare UPIN