Healthcare Provider Details
I. General information
NPI: 1811168156
Provider Name (Legal Business Name): NEIL SAUNDERS DPM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2008
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 W ALEXIS RD
TOLEDO OH
43613-5445
US
IV. Provider business mailing address
3030 W SYLVANIA AVE SUITE 105
TOLEDO OH
43613-4100
US
V. Phone/Fax
- Phone: 419-480-1013
- Fax:
- Phone: 419-474-3338
- Fax: 419-474-5193
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 36002506 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | 36002506 |
| License Number State | OH |
VIII. Authorized Official
Name:
NEIL
E.
SAUNDERS
Title or Position: OWNER
Credential: DPM
Phone: 419-474-3338