Provider Demographics
NPI:1316161953
Name:TRUMBULL FOOT HEALTH, INC.
Entity type:Organization
Organization Name:TRUMBULL FOOT HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
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 1:2537 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6257
Practice Address - Country:US
Practice Address - Phone:330-372-5500
Practice Address - Fax:330-372-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OH1979213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0473714Medicaid
OH0473714Medicaid
OH5199180001Medicare NSC