MEDICARE: MOBILE FOOT CARE PC

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	5901001763	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480F318900	OTHER	MI	BC

General Provider Information

NPI Number	:	1457450702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE FOOT CARE PC

Provider Business Mailing Address
First Line	:	PO BOX 337
Second Line	:
City	:	HARTLAND
State	:	MI
Zip	:	48353
Country	:	US
Telephone Number	:	517-548-4738
Fax Number	:	517-548-4752

Provider Business Practice Location Address
First Line	:	301 LAKE MEADOW DR
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48327-1785
Country	:	US
Telephone Number	:	313-565-2111
Fax Number	:	313-565-0944

Authorized Official
Title or Position	:	OWNER
Name	:	RAJEEV SEHGAL
Credential	:	DPM
Telephone Number	:	313-565-2111

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/23/2008

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Directions to “MOBILE FOOT CARE PC ” Practice Location

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