| Organization Name: | SHELBY FOOT & ANKLE PLLC |
| NPI Number: | 1578993358 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD MARTIN (OWNER) |
| Mailing Address: | 4091 W Vienna Rd Clio |
| State: | MI US |
| Postal Code: | 484209437 |
| Phone Number: | 8106877350 |
| Fax Number: | 8106877360 |
| NPI Enumeration Date: | 11/15/2013 |
| NPI Last Update Date: | 11/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | RM002147 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |