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General NPI Number Information
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NPI Number | 1356694053
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Entity Type | Organization
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Legal Business Name | CORNERSTONE FOOT AND ANKLE INC
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 06/30/2016
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Provider Practice Location Address
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Address Line | 15 SOUTHMOOR CIR NE
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City | DAYTON
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State | OH
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Zip | 45429-2451
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Country | US
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Telephone | 937-293-6896
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Fax | 937-293-9150
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Provider Business Mailing Address
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Address Line | 15 SOUTHMOOR CIR NE
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City | DAYTON
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State | OH
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Zip | 45429-2451
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Country | US
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Telephone | 937-293-6896
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Fax | 937-293-9150
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Authorized Official
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Title or Position | DPM
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Name | BRIAN A KUVSHINIKOV
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Credential | DPM
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Telephone | 937-293-6896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36003316
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License Number State | OH
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