Healthcare Provider Details

I. General information

NPI: 1316161953
Provider Name (Legal Business Name): TRUMBULL FOOT HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2537 E MARKET ST
WARREN OH
44483-6257
US

IV. Provider business mailing address

2537 E MARKET ST
WARREN OH
44483-6257
US

V. Phone/Fax

Practice location:
  • Phone: 330-372-5500
  • Fax: 330-372-3536
Mailing address:
  • Phone: 330-372-5500
  • Fax: 330-372-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1979
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL G WARSHAW
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 330-372-5500