Organization Name: | NORTH EASTERN OHIO PODIATRY GROUP LLC |
NPI Number: | 1447529656 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VADIM GLUKH (PARTNER) |
Mailing Address: | 35010 Chardon Rd Suite 101a Willoughby Hills |
State: | OH US |
Postal Code: | 440949011 |
Phone Number: | 4409533668 |
Fax Number: | 4409533556 |
NPI Enumeration Date: | 12/16/2011 |
NPI Last Update Date: | 07/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |