Provider Demographics
NPI:1992917157
Name:STEVEN J NEIRINK, DPM, PC
Entity type:Organization
Organization Name:STEVEN J NEIRINK, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JON
Authorized Official - Last Name:NEIRINK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:810-715-2500
Mailing Address - Street 1:3014 S GENESEE RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1420
Mailing Address - Country:US
Mailing Address - Phone:810-715-2500
Mailing Address - Fax:810-715-2524
Practice Address - Street 1:3014 SOUTH GENESEE ROAD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519
Practice Address - Country:US
Practice Address - Phone:810-715-2500
Practice Address - Fax:810-715-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISN001846213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU66391Medicare UPIN
MIN58540001Medicare ID - Type Unspecified
MI0655530001Medicare NSC