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Organization
MIDWEST FOOTCARE, INC.
Active
Organization
MIDWEST FOOTCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS MICHAEL VICHINSKY D.P.M. (CEO)
(937) 642-9936
Entity
Organization
Contact information
Practice address
245 STOCKSDALE DR, MARYSVILLE, OH 43040-1563
(937) 642-9936
(937) 642-5537
Mailing address
245 STOCKSDALE DR, MARYSVILLE, OH 43040-1563
(937) 642-9936
(937) 642-5537
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36-00-1774-V
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000066784
ANTHEM BC
—
01
—
102085A
ALLIANCE BC
—
05
—
2457934
—
OH
01
—
431803548
CHAMPUS
—
01
—
DB2142
RAILROAD MEDICARE
—
Enumeration date
08/23/2007
Last updated
04/20/2008
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