Basic Information
| Provider Information | |||||||||
| NPI: | 1700860087 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELEWSKY | ||||||||
| FirstName: | MARIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3950 S ROCHESTER RD | ||||||||
| Address2: | SUITE 1200 | ||||||||
| City: | ROCHESTER HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483075160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488446000 | ||||||||
| FaxNumber: | 2488446159 | ||||||||
| Practice Location | |||||||||
| Address1: | 3950 S ROCHESTER RD | ||||||||
| Address2: | SUITE 1200 | ||||||||
| City: | ROCHESTER HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483075160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488446000 | ||||||||
| FaxNumber: | 2488446159 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 04/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 5901001394 | MI | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 2845800 | 05 | MI | MEDICAID |