Healthcare Provider Details

I. General information

NPI: 1538156427
Provider Name (Legal Business Name): STEUBENVILLE ORTHOPEDICS & SPORTS MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 JOHNSON RD SUITE 102
STEUBENVILLE OH
43952-2356
US

IV. Provider business mailing address

PO BOX 3144
WEIRTON WV
26062-7144
US

V. Phone/Fax

Practice location:
  • Phone: 740-283-2062
  • Fax: 740-283-2049
Mailing address:
  • Phone: 740-282-2576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35070678
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number35070678
License Number StateOH

VIII. Authorized Official

Name: DR. KUMAR B AMIN
Title or Position: OWNER
Credential: MD
Phone: 740-283-2062