Healthcare Provider Details

I. General information

NPI: 1356447205
Provider Name (Legal Business Name): KEVIN M. KANE D.P.M. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7393 BROADVIEW RD SUITE F
SEVEN HILLS OH
44131-4444
US

IV. Provider business mailing address

7393 BROADVIEW RD SUITE F
SEVEN HILLS OH
44131-4444
US

V. Phone/Fax

Practice location:
  • Phone: 216-642-3668
  • Fax: 216-573-0769
Mailing address:
  • Phone: 216-642-3668
  • Fax: 216-573-0769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36002425
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number36002425
License Number StateOH

VIII. Authorized Official

Name: KEVIN MICHAEL KANE
Title or Position: PRESIDENT
Credential: DPM
Phone: 216-642-3668