OrganizationActive
Lake Podiatry, PC
NPI 1063449346 · Foot & Ankle Surgery Podiatrist · South Haven, MI
Provider details
- NPI number
- 1063449346
- Entity type
- Organization
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Raziuddin Ahmed, President & Ceo(818) 518-6768
- License
- 5901002029 (MI)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10570 Blue Star M Hwy
South Haven, MI 49090-8923
Phone: (269) 978-3385
Fax: (269) 978-2711
Street-level locationGet directions
Mailing address
10570 Blue Star M Hwy
South Haven, MI 49090-8923
Registry dates
- Enumerated
- 2006-06-26
- Last updated
- 2009-05-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.