Provider Demographics
NPI:1114069044
Name:FAMILY FOOTCARE PC
Entity Type:Organization
Organization Name:FAMILY FOOTCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-851-4900
Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE L40
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3230
Mailing Address - Country:US
Mailing Address - Phone:248-851-4900
Mailing Address - Fax:248-851-4901
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:SUITE L40
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-851-4900
Practice Address - Fax:248-851-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P18180Medicare PIN
MI0P18280Medicare PIN
MI5427460001Medicare NSC