=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962501205
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METROPOLITAN FOOT CARE SERVICES PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2006
-----------------------------------------------------
Last Update Date | 04/28/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25135 W WARREN
-----------------------------------------------------
City | DEARBORN HEIGHTS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48127-2146
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-565-2111
-----------------------------------------------------
Fax | 313-565-0944
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 337 METROPOLITAN FOOT CARE SERVICES PC
-----------------------------------------------------
City | HARTLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-565-2111
-----------------------------------------------------
Fax | 313-565-0944
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RAJEEV SEHGAL
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 313-565-2111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 5901001763
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------