Provider Demographics
NPI:1922315639
Name:FOOT CARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:FOOT CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:T
Authorized Official - Last Name:MOHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-670-3275
Mailing Address - Street 1:3184 W BROAD ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1327
Mailing Address - Country:US
Mailing Address - Phone:614-274-7448
Mailing Address - Fax:614-274-4498
Practice Address - Street 1:3184 W BROAD ST
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1327
Practice Address - Country:US
Practice Address - Phone:614-274-7448
Practice Address - Fax:614-274-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003305213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000510898OtherANTHEM
P00372468OtherRAILROAD MEDICARE
OH2375826OtherMCD-INDIVIDUAL-MTM
OH3090597Medicaid
OH4103245OtherMC-INDIVIDUAL PIN-MTM
N463943OtherWELLCARE
292728860-00OtherBWC
9391401Medicare PIN
N463943OtherWELLCARE