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Contact Information

BLUE WATER PODIATRY PC
1060 S VAN DYKE RD
SUITE 100
BAD AXE, MI48413-9631
 Phone: 989-269-9575
 Fax: 989-269-9576
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BLUE WATER PODIATRY PC

NPI Number 1447397138
LBN Legal business name BLUE WATER PODIATRY PC
Authorized official THOMAS ERNST - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2007
Last updated 01/20/2010 - About 16 years ago
Identifiers
MI License # 59000955
MI Medicaid 1958354
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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