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General NPI Number Information
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NPI Number | 1003981820
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Entity Type | Organization
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Legal Business Name | ELEVATE FOOT & ANKLE INC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3628 WALNUT HILLS AVE STE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-4484
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Country | US
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Telephone | 216-381-3600
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Fax | 216-381-5981
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Provider Business Mailing Address
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Address Line | 2880 PLYMOUTH AVE
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3209
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Country | US
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Telephone | 440-333-5888
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Fax | 440-333-6766
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID A KRETCH
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Credential | DPM
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Telephone | 216-381-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 826250
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License Number State | OH
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