| Organization Name: | OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC |
| NPI Number: | 1003204967 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN A. KUVSHINIKOV (PODIATRIST) |
| Mailing Address: | 7529 State Rd Suite B Cincinnati |
| State: | OH US |
| Postal Code: | 452556409 |
| Phone Number: | 5132326600 |
| Fax Number: | 5132327529 |
| NPI Enumeration Date: | 12/30/2014 |
| NPI Last Update Date: | 12/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 36-003316 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |