MEDICARE: DR. ANDREW JAY CUSHER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	36.001899	OH

General Provider Information

NPI Number	:	1205899895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JAY CUSHER DPM

Provider Business Mailing Address
First Line	:	3377 COMPTON RD
Second Line	:	140
City	:	CINCINNATI
State	:	OH
Zip	:	45251-2506
Country	:	US
Telephone Number	:	513-385-9236
Fax Number	:	513-385-9236

Provider Business Practice Location Address
First Line	:	3377 COMPTON RD
Second Line	:	140
City	:	CINCINNATI
State	:	OH
Zip	:	45251-2506
Country	:	US
Telephone Number	:	513-385-9236
Fax Number	:	513-385-9236

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	07/08/2007

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