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NPI Code Detail

MEDICARE: RICHMOND FOOT & ANKLE CARE, INC.

MEDICARE: RICHMOND FOOT & ANKLE CARE, 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
1213ES0103XFoot & Ankle Surgery Podiatrist36003112OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942295001
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHMOND FOOT & ANKLE CARE, INC.
Provider Business Mailing Address
First Line : 464 RICHMOND RD
Second Line : SUITE 201
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2704
Country : US
Telephone Number : 216-481-6654
Fax Number : 216-481-3185
Provider Business Practice Location Address
First Line : 464 RICHMOND RD
Second Line : SUITE 201
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2704
Country : US
Telephone Number : 216-481-6654
Fax Number : 216-481-3185
Authorized Official
Title or Position : PHYSICIAN
Name : DR. VADIM GLUKH
Credential : DPM
Telephone Number : 216-481-6654
Provider Enumeration Date : 09/15/2005
Last Update Date : 12/05/2011

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Directions to “RICHMOND FOOT & ANKLE CARE, INC. ” Practice Location

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