Provider Demographics
NPI:1982748299
Name:GENTLE HOME FOOT CARE INC
Entity Type:Organization
Organization Name:GENTLE HOME FOOT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-393-8611
Mailing Address - Street 1:3122 PARK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2061
Mailing Address - Country:US
Mailing Address - Phone:810-690-7483
Mailing Address - Fax:810-690-7483
Practice Address - Street 1:3122 PARK MEADOW DR
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-2061
Practice Address - Country:US
Practice Address - Phone:810-690-7483
Practice Address - Fax:810-690-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDS001654213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P42640Medicare PIN