Provider Demographics
NPI:1922146968
Name:TRUMBULL FOOT HEALTH, INC
Entity Type:Organization
Organization Name:TRUMBULL FOOT HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.M.
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:WARSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-372-5500
Mailing Address - Street 1:2537 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6257
Mailing Address - Country:US
Mailing Address - Phone:330-372-5500
Mailing Address - Fax:330-372-3536
Practice Address - Street 1:27378 W OVIATT RD
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2139
Practice Address - Country:US
Practice Address - Phone:440-871-4700
Practice Address - Fax:440-871-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001979W213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9286341OtherOHIO MEDICARE GROUP NUM
OH0473714Medicaid
OHU10326Medicare UPIN
OH0503417Medicare PIN