Provider Demographics
NPI:1891914214
Name:PHOENIX INSTITUTE OF FOOTCARE PHYSICANS, PLC
Entity Type:Organization
Organization Name:PHOENIX INSTITUTE OF FOOTCARE PHYSICANS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SCHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:602-462-1497
Mailing Address - Street 1:4530 N 32ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3357
Mailing Address - Country:US
Mailing Address - Phone:602-462-1497
Mailing Address - Fax:602-462-1498
Practice Address - Street 1:4530 N 32ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3357
Practice Address - Country:US
Practice Address - Phone:602-462-1497
Practice Address - Fax:602-462-1498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0495213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4781350001Medicare NSC