Provider Demographics
NPI:1427071497
Name:FOOT CARE NETWORK PC
Entity type:Organization
Organization Name:FOOT CARE NETWORK PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NASRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OVEYS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-524-9994
Mailing Address - Street 1:55 E LONG LAKE RD STE 472
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4738
Mailing Address - Country:US
Mailing Address - Phone:248-524-9994
Mailing Address - Fax:248-524-9995
Practice Address - Street 1:35450 DEQUINDRE RD STE 106
Practice Address - Street 2:
Practice Address - City:STERLING HTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4810
Practice Address - Country:US
Practice Address - Phone:248-524-9994
Practice Address - Fax:248-524-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINO001696213E00000X
MIKK001963213E00000X
MIJS00061O213E00000X
261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI480F328410OtherBC
MI314235Medicaid