MEDICARE: BLUE WATER PODIATRY 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	59000955	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760529705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE WATER PODIATRY PC

Provider Business Mailing Address
First Line	:	5303 SHOREWOOD DR
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-3137
Country	:	US
Telephone Number	:	810-385-2053
Fax Number	:

Provider Business Practice Location Address
First Line	:	828 10TH AVE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-3640
Country	:	US
Telephone Number	:	810-982-4240
Fax Number	:	810-982-2479

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS K ERNST
Credential	:	DPM
Telephone Number	:	810-982-4240

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	10/19/2007

Similar Medicare Providers

1174520274 — DR. THOMAS KEVIN ERNST DPM
Practice Location Address:

828 10TH AVE
PORT HURON, MI
48060-3640

Practice Phone: 810-982-4240
Practice Fax: 810-982-2479

1780542100 — ELEVATE APPLIED BEHAVIOR ANALYSIS CONSULTING LLC
Practice Location Address:

48 BROWN THRASHER CT
PORT WENTWORTH, GA
31407-3640

Practice Phone: 502-435-2010
Practice Fax:

1922433887 — CHELSIE COASTER RD, CDE
Practice Location Address:

2024 16TH ST
PORT HURON, MI
48060-6135

Practice Phone: 586-531-3096
Practice Fax:

1891654018 — MOTIVATE LLC
Practice Location Address:

1302 LAPEER AVE
PORT HURON, MI
48060-4354

Practice Phone: 708-271-3518
Practice Fax:

1144866013 — CASEY RENNO AGNP-C
Practice Location Address:

1210 10TH AVE
PORT HURON, MI
48060-3406

Practice Phone: 810-662-3505
Practice Fax:

1023879657 — MRS. KAITLYN MARIE MAHAFFY
Practice Location Address:

1210 10TH AVE
PORT HURON, MI
48060-3406

Practice Phone: 810-662-3505
Practice Fax:

Directions to “BLUE WATER PODIATRY PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.