Provider Demographics
NPI:1235109968
Name:MIDLAND FAMILY FOOTCARE,.L.L.C.
Entity Type:Organization
Organization Name:MIDLAND FAMILY FOOTCARE,.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:989-631-0200
Mailing Address - Street 1:2924 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4443
Mailing Address - Country:US
Mailing Address - Phone:989-631-0200
Mailing Address - Fax:989-631-2210
Practice Address - Street 1:2924 MANOR DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4443
Practice Address - Country:US
Practice Address - Phone:989-631-0200
Practice Address - Fax:989-631-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
480022610OtherRAILROAD MEDICARE
MI480E61016 0OtherBCBSMI
0M40860Medicare ID - Type Unspecified
1325780001Medicare NSC