Provider Demographics
NPI:1780864249
Name:STERLING FAMILY FOOT CARE PC
Entity Type:Organization
Organization Name:STERLING FAMILY FOOT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SOLWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:586-323-3668
Mailing Address - Street 1:43330 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-2022
Mailing Address - Country:US
Mailing Address - Phone:586-323-3668
Mailing Address - Fax:586-323-4120
Practice Address - Street 1:43330 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-2022
Practice Address - Country:US
Practice Address - Phone:586-323-3668
Practice Address - Fax:586-323-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS001142213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3233383Medicaid
MIJS001142OtherLICENSE
MIJS001142OtherLICENSE
MI3233383Medicaid