Clawson Footcare Specialists PC

Organization Active NPI Podiatric Clinic/Center · Clawson, MI

NPI 1215029418 · NPPES record last updated Nov 13, 2012

Key facts

NPI
1215029418
Entity type
Organization (NPI type 2)
Primary specialty
Podiatric Clinic/Center 261QP1100X
License
5901001699 (MI)
Legal business name
CLAWSON FOOTCARE SPECIALISTS PC
Practice address
615 W 14 Mile Rd
Clawson, MI 48017-1901
Phone
(248) 288-8900
Fax
(248) 288-8989
NPI assigned
Sep 28, 2006
Organization subpart
No

Authorized official

Name
Dr. Brian E Homer, D.P.M, P.C. NPI 1326024183
Title
Owner
Phone
(248) 288-8900

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930079020 MI DME Supplier - Physician - Podiatry 3274654520 Practice locations: Clawson, MI
O20121113000610 MI Part B Supplier - Clinic/Group Practice 3274654520 Receives reassigned benefits from 2 practitioners
Practice locations: Clawson, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X 5901001699 MI Yes
Durable Medical Equipment & Medical Supplies 332B00000X 5901001699 MI
Prosthetic/Orthotic Supplier 335E00000X 5901001699 MI

Addresses

Primary practice location

615 W 14 Mile Rd
Clawson, MI 48017-1901

Mailing address

615 W. 14 Mile Road
Clawson, MI 48017-1901
Phone (248) 288-8900

Other identifiers

IdentifierTypeStateIssuer
133153308MedicaidMI
480018640OtherMIRAILROAD MEDICARE
0F383890OtherMIBCBSMI DME
1283450001OtherMIMEDICARE DME
0F31808OtherMIBCBSMI

Other names

  • Brian E. Homer Other name

Other providers in Clawson, MI

All providers in Clawson, MI · Podiatric Clinic/Center in Michigan

Sources for this page

Verify at the official NPI Registry.