Provider Demographics
NPI:1649419300
Name:TOTAL LOVING CARE & PODIATRIC SERVICES, P.C.
Entity Type:Organization
Organization Name:TOTAL LOVING CARE & PODIATRIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:LASHA
Authorized Official - Last Name:LOVING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:313-581-4325
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48121-1845
Mailing Address - Country:US
Mailing Address - Phone:313-581-4325
Mailing Address - Fax:313-582-4325
Practice Address - Street 1:15324 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2917
Practice Address - Country:US
Practice Address - Phone:313-581-4325
Practice Address - Fax:313-582-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002009213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992734727Medicaid
MI0H20551OtherBLUE CROSS
MI1992734727Medicaid