Healthcare Provider Details

I. General information

NPI: 1083545677
Provider Name (Legal Business Name): SURESTEP FOOT & ANKLE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 CHEVIOT RD STE 100
CINCINNATI OH
45247-4013
US

IV. Provider business mailing address

11821 MASON MONTGOMERY RD UNIT 4B
CINCINNATI OH
45249-3705
US

V. Phone/Fax

Practice location:
  • Phone: 513-489-2400
  • Fax: 513-489-2455
Mailing address:
  • Phone: 513-489-2400
  • Fax: 513-489-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THERESA M FAUVER
Title or Position: CRED MGR
Credential:
Phone: 440-357-8418