Provider Demographics
NPI:1538249982
Name:NSIMA USEN DPM, MPH, P.C
Entity type:Organization
Organization Name:NSIMA USEN DPM, MPH, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-352-3736
Mailing Address - Street 1:27177 LAHSER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-8468
Mailing Address - Country:US
Mailing Address - Phone:248-352-3736
Mailing Address - Fax:
Practice Address - Street 1:27177 LAHSER RD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-8468
Practice Address - Country:US
Practice Address - Phone:248-352-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002130213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4820453Medicaid
MI4820453Medicaid
MI0P21200Medicare ID - Type Unspecified