MEDICARE: DR. LANNY STUART FOSTER DPM

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	213E00000X	Podiatrist	5901001152	MI

General Provider Information

NPI Number	:	1356365431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANNY STUART FOSTER DPM

Provider Business Mailing Address
First Line	:	31390 NORTHWESTERN HWY
Second Line	:	STE. E
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2561
Country	:	US
Telephone Number	:	248-855-6888
Fax Number	:	248-855-1068

Provider Business Practice Location Address
First Line	:	31390 NORTHWESTERN HWY
Second Line	:	STE. E
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2561
Country	:	US
Telephone Number	:	248-855-6888
Fax Number	:	248-855-1068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	05/12/2008

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