Provider Demographics
NPI:1831169853
Name:DOWNRIVER PODIATRISTS, P.C.
Entity type:Organization
Organization Name:DOWNRIVER PODIATRISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARONOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:586-264-7300
Mailing Address - Street 1:31730 HOOVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-1700
Mailing Address - Country:US
Mailing Address - Phone:586-264-7300
Mailing Address - Fax:586-268-4630
Practice Address - Street 1:31730 HOOVER RD STE B
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093
Practice Address - Country:US
Practice Address - Phone:586-264-7300
Practice Address - Fax:586-268-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICL5532OtherRAILROAD MEDICARE
MI480Q26490OtherBCBS
MICL5532OtherRAILROAD MEDICARE
MI=========OtherPPOM