Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Podiatry, PC

Organization Foot & Ankle Surgery Podiatrist · NPI 1063449346

Lake Podiatry, PC is a Foot & Ankle Surgery Podiatrist in South Haven, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10570 Blue Star M Hwy
South Haven, MI 49090-8923
Phone: (269) 978-3385
Fax: (269) 978-2711
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 5901002029 (MI)

Record details

NPI number1063449346
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raziuddin Ahmed — President & Ceo · (818) 518-6768
NPI enumeratedJune 26, 2006
Last updated in NPPESMay 29, 2009
Mailing address10570 Blue Star M Hwy, South Haven, MI 49090-8923

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