Provider Demographics
NPI:1114912771
Name:BITOFF, LOUIS JR (DPM)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:BITOFF
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:LOUIS
Other - Middle Name:
Other - Last Name:BITOFF
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:29560 BRADMOOR CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3264
Mailing Address - Country:US
Mailing Address - Phone:734-632-1145
Mailing Address - Fax:248-522-6084
Practice Address - Street 1:17515 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4403
Practice Address - Country:US
Practice Address - Phone:248-569-4000
Practice Address - Fax:248-569-5771
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000723213EP1101X, 213ES0000X, 213ES0103X, 213ER0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4844437Medicaid
MIP00322027OtherRAILROAD MEDICARE
MI4856316770OtherBLUE CROSS BLUE SHIELD MICHIGAN
MI480F37288OtherNEW BARNA BC PIN
MI480F37288OtherNEW BARNA BC PIN
MI0F37288028Medicare PIN
MI5825517Medicare PIN
MIP00322027OtherRAILROAD MEDICARE