Nishon, Larry R

Nishon, Larry R is an individual health care provider with primary practice located at 2158 Commons Pkwy , Okemos MI 48864-3986. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Nishon, Larry R can be contacted via phone (517) 349-6855.

Contact Information

Primary practice address
2158 Commons Pkwy Okemos MI 48864-3986
Phone: (517) 349-6855
Fax: (517) 349-7158
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X LN001085 Michigan
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X LN001085 Michigan

Profile Details

NPI number 1245239631
LBN Legal business name Nishon, Larry R
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245239631 NPPES
Michigan MEDICAID 1710897
Michigan Other 4814430001
Michigan Other 2700008
Michigan Other 4814430002

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