Provider Demographics
NPI:1356365431
Name:FOSTER, LANNY STUART (DPM)
Entity type:Individual
Prefix:DR
First Name:LANNY
Middle Name:STUART
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:31390 NORTHWESTERN HWY
Mailing Address - Street 2:STE. E
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2561
Mailing Address - Country:US
Mailing Address - Phone:248-855-6888
Mailing Address - Fax:248-855-1068
Practice Address - Street 1:31390 NORTHWESTERN HWY
Practice Address - Street 2:STE. E
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2561
Practice Address - Country:US
Practice Address - Phone:248-855-6888
Practice Address - Fax:248-855-1068
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5901001152213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT34156Medicare UPIN
0661430001Medicare NSC
MI5635117Medicare PIN
MIP55490001Medicare PIN