Healthcare Provider Details

I. General information

NPI: 1114069044
Provider Name (Legal Business Name): FAMILY FOOTCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30055 NORTHWESTERN HWY SUITE L40
FARMINGTON HILLS MI
48334-3230
US

IV. Provider business mailing address

29355 NORTHWESTERN HWY STE 110
SOUTHFIELD MI
48034-1065
US

V. Phone/Fax

Practice location:
  • Phone: 248-851-4900
  • Fax: 248-851-4901
Mailing address:
  • Phone: 248-851-4900
  • Fax: 248-945-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: MILTON J STERN
Title or Position: DOCTOR
Credential: DPM
Phone: 248-945-1000