Provider Demographics
NPI:1629007422
Name:FHPIM, PLC
Entity Type:Organization
Organization Name:FHPIM, PLC
Other - Org Name:FOOT AND HEEL PAIN INSTITUTE OF MICHIGAN, PLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:LONG
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-557-6500
Mailing Address - Street 1:29425 NORTHWESTERN HWY STE 125
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1083
Mailing Address - Country:US
Mailing Address - Phone:248-557-6500
Mailing Address - Fax:248-557-2781
Practice Address - Street 1:29425 NORTHWESTERN HWY STE 125
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1083
Practice Address - Country:US
Practice Address - Phone:248-557-6500
Practice Address - Fax:248-557-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI480F328920OtherBLUE CROSS
MI4842666Medicaid
MI4842666Medicaid
MI5569720001Medicare NSC