Provider Demographics
NPI:1942950001
Name:PROGRESSIVE PODIATRY PLC
Entity type:Organization
Organization Name:PROGRESSIVE PODIATRY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASMAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABADA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:313-377-6557
Mailing Address - Street 1:27789 MOUND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2697
Mailing Address - Country:US
Mailing Address - Phone:313-209-3353
Mailing Address - Fax:313-406-7255
Practice Address - Street 1:27789 MOUND RD STE 200
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2697
Practice Address - Country:US
Practice Address - Phone:313-209-3353
Practice Address - Fax:313-406-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty