MEDICARE: TRUMBULL FOOT HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	213E00000X	Podiatrist	1979	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316161953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUMBULL FOOT HEALTH, INC.

Provider Business Mailing Address
First Line	:	2537 E MARKET ST
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-6257
Country	:	US
Telephone Number	:	330-372-5500
Fax Number	:	330-372-3536

Provider Business Practice Location Address
First Line	:	2537 E MARKET ST
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-6257
Country	:	US
Telephone Number	:	330-372-5500
Fax Number	:	330-372-3536

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL G WARSHAW
Credential	:	D.P.M.
Telephone Number	:	330-372-5500

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	04/18/2008

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