| Organization Name: | NORTH EASTERN OHIO PODIATRY GROUP,LLC |
| NPI Number: | 1508100660 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HOWARD M WAXMAN (PHYSICIAN/PARTNER/OWNER) |
| Mailing Address: | 7954 Broadview Rd Broadview Heights |
| State: | OH US |
| Postal Code: | 441471202 |
| Phone Number: | 4409533668 |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 12/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |