Provider Demographics
NPI:1386523124
Name:PURE MICHIGAN FOOT AND ANKLE PLLC
Entity type:Organization
Organization Name:PURE MICHIGAN FOOT AND ANKLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANI
Authorized Official - Middle Name:
Authorized Official - Last Name:DABAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-565-7112
Mailing Address - Street 1:2034 LAKE WIND DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1823
Mailing Address - Country:US
Mailing Address - Phone:248-565-7112
Mailing Address - Fax:
Practice Address - Street 1:2221 LIVERNOIS RD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1603
Practice Address - Country:US
Practice Address - Phone:248-565-7112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty