Provider Demographics
NPI:1114300530
Name:FOREMOST PODIATRY, P.C.
Entity Type:Organization
Organization Name:FOREMOST PODIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:K
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:517-882-8673
Mailing Address - Street 1:3390 E JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-8547
Mailing Address - Country:US
Mailing Address - Phone:517-882-8673
Mailing Address - Fax:517-882-3935
Practice Address - Street 1:3390 E JOLLY RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-8547
Practice Address - Country:US
Practice Address - Phone:517-882-8673
Practice Address - Fax:517-882-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002238213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5901002238OtherMICHIGAN STATE LICENSE NUMBER