MEDICARE: FOREST HILLS PODIATRY

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	MT001332	MI

General Provider Information

NPI Number	:	1447455415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST HILLS PODIATRY

Provider Business Mailing Address
First Line	:	4915 CASCADE RD SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-3722
Country	:	US
Telephone Number	:	616-942-5061
Fax Number	:

Provider Business Practice Location Address
First Line	:	4915 CASCADE RD SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-3722
Country	:	US
Telephone Number	:	616-942-5061
Fax Number	:

Authorized Official
Title or Position	:	PHYISICAN
Name	:	DR. MICHAEL J TROMPEN
Credential	:	DPM
Telephone Number	:	616-942-5061

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	09/13/2008

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