Provider Demographics
NPI:1558398818
Name:FOOT HEALTHCARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:FOOT HEALTHCARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MOZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-258-0001
Mailing Address - Street 1:37595 7 MILE RD
Mailing Address - Street 2:SUITE370
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1003
Mailing Address - Country:US
Mailing Address - Phone:248-258-0001
Mailing Address - Fax:248-258-6779
Practice Address - Street 1:32270 TELEGRAPH RD STE 250
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-2405
Practice Address - Country:US
Practice Address - Phone:248-258-0001
Practice Address - Fax:248-258-6779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001143213ES0103X
MI5901001932213ES0103X
MI5901002091213ES0103X
MI5901002138213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5901001143OtherPODIATRIC PHYSICIAN & SUR
MI5901002091OtherPODIATRIC PHYSICIAN & SUR
MI1174507172OtherNPI
MI2927076Medicaid
MI4687818Medicaid
MI1215913694OtherNPI
MI1649261348OtherNPI
MI59101002138OtherPODIATRIC PHYSICIAN & SUR
MI1023052081OtherNPI
MI1902096902OtherPALMETTO
MI5901001932OtherPODIATRIC PHYSICIAN & SUR
MI4183061Medicaid
MI4183061Medicaid
MI1174507172OtherNPI
MI2927076Medicaid
MI1023052081OtherNPI
MIF36404048Medicare ID - Type Unspecified
MI0F36404002Medicare ID - Type Unspecified
MI5901002091OtherPODIATRIC PHYSICIAN & SUR