MEDICARE: PODIATRY ASSOCIATES OF CINCINNATI INC

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	213ES0103X	Foot & Ankle Surgery Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CK5052	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000251377	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1629162417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODIATRY ASSOCIATES OF CINCINNATI INC

Provider Business Mailing Address
First Line	:	4357 FERGUSON DR STE 150
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1760
Country	:	US
Telephone Number	:	513-474-4450
Fax Number	:	513-474-6387

Provider Business Practice Location Address
First Line	:	4357 FERGUSON DR STE 150
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1760
Country	:	US
Telephone Number	:	513-474-4450
Fax Number	:	513-474-6387

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	DAWN GRINSPAN
Credential	:
Telephone Number	:	513-474-4450

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/11/2020

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Directions to “PODIATRY ASSOCIATES OF CINCINNATI INC ” Practice Location

Language	Start Address	Practice Location

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