NPI 1891222964 · live from the CMS NPI Registry
Samuel Thaddeus Austin, DPM
Podiatrist in Dearborn, MI. National Provider Identifier 1891222964, active.
NPI record
| NPI | 1891222964 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 22720 Michigan Ave Ste 175, Dearborn, MI 48124 |
| Practice phone | 248-717-0000 |
| Enumerated | May 18, 2017 |
| Last updated | January 22, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 5901400369 (MI) |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 5901400369 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.