Provider Demographics
NPI:1528103009
Name:ASSOCIATED PODIATRISTS PC
Entity type:Organization
Organization Name:ASSOCIATED PODIATRISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOROVOY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-348-5300
Mailing Address - Street 1:26750 PROVIDENCE PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1211
Mailing Address - Country:US
Mailing Address - Phone:248-348-5300
Mailing Address - Fax:248-348-5410
Practice Address - Street 1:26750 PROVIDENCE PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1211
Practice Address - Country:US
Practice Address - Phone:248-348-5300
Practice Address - Fax:248-348-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI480F372470OtherBLUE CROSS BLUE SHIELD MI
MI0F37247Medicare ID - Type Unspecified
MI0175520001Medicare NSC