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General NPI Number Information
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NPI Number | 1306863238
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Entity Type | Organization
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Legal Business Name | SALVATORE P. SIDOTI, DPM INC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 6681 RIDGE RD SUITE 405
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City | PARMA
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State | OH
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Zip | 44129-5705
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Country | US
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Telephone | 440-884-4114
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Fax | 440-884-7661
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Provider Business Mailing Address
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Address Line | 6681 RIDGE RD SUITE 405
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City | PARMA
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State | OH
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Zip | 44129-5705
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Country | US
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Telephone | 440-884-4114
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Fax | 440-884-7661
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Authorized Official
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Title or Position | OWNER
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Name | SALVATORE PATRICK SIDOTI
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Credential |
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Telephone | 440-884-4114
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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 | 36.002376
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License Number State | OH
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