Provider Demographics
NPI:1407728108
Name:EPIC FOOT & ANKLE SPECIALISTS PLLC
Entity type:Organization
Organization Name:EPIC FOOT & ANKLE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOHOMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-SAWAH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:989-895-8594
Mailing Address - Street 1:720 LIVINGSTON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6392
Mailing Address - Country:US
Mailing Address - Phone:989-895-8594
Mailing Address - Fax:989-895-8748
Practice Address - Street 1:720 LIVINGSTON ST STE 1
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6392
Practice Address - Country:US
Practice Address - Phone:989-895-8594
Practice Address - Fax:989-895-8748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty