Healthcare Provider Details

I. General information

NPI: 1669643136
Provider Name (Legal Business Name): NEIL SAUNDERS DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 10/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 NAVARRE AVE SUITE 101, BLDG A
OREGON OH
43616-3275
US

IV. Provider business mailing address

3030 W SYLVANIA AVE SUITE 105
TOLEDO OH
43613-4100
US

V. Phone/Fax

Practice location:
  • Phone: 419-691-3668
  • Fax: 419-474-5193
Mailing address:
  • Phone: 419-474-3338
  • Fax: 419-474-5193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36002506
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number36.002506
License Number StateOH

VIII. Authorized Official

Name: NEIL E. SAUNDERS
Title or Position: OWNER
Credential: DPM
Phone: 419-474-3338