| Doctor Name: | JAMES EDWIN PROMMERSBERGER |
| NPI Number: | 1073584686 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 36-00-2619 |
| Business Practice Address: | 940 Windham Ct Suite #3 Boardman, OH - 445125060 |
| Business Phone Number: | 3307263348 |
| Business Fax Number: | 3307263856 |
| Mailing Address: | 940 Windham Ct, Suite #3 BOARDMAN |
| State: | OH |
| Postal Code: | 445125060 |
| Phone Number: | 3307263348 |
| Fax Number: | 3307263856 |
| NPI Enumeration Date: | 01/31/2006 |
| NPI Last Update Date: | 06/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 36-00-2619 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |