| Organization Name: | ORTONVILLE FOOT & ANKLE CENTER PC |
| NPI Number: | 1770763849 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN WARREN WITTENBERG (OWNER) |
| Mailing Address: | 1221 S Ortonville Rd Ortonville |
| State: | MI US |
| Postal Code: | 484628676 |
| Phone Number: | 2486275700 |
| Fax Number: | 2486276519 |
| NPI Enumeration Date: | 11/06/2007 |
| NPI Last Update Date: | 05/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SW000585 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |