Provider Demographics
NPI:1912116807
Name:7-HUNTINGTON PODIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:7-HUNTINGTON PODIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:313-534-4244
Mailing Address - Street 1:19350 WEST SEVEN MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219
Mailing Address - Country:US
Mailing Address - Phone:313-534-4244
Mailing Address - Fax:313-535-7813
Practice Address - Street 1:19350 WEST SEVEN MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219
Practice Address - Country:US
Practice Address - Phone:313-534-4244
Practice Address - Fax:313-535-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4856318250OtherBCBSM
MI1507818Medicaid
MI4900720001Medicare NSC
MIT97388Medicare UPIN
MI4856318250OtherBCBSM