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General NPI Number Information
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NPI Number | 1790704807
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Entity Type | Organization
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Legal Business Name | MARK STIEBY D.P.M. LLC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3012 GLENMORE AVE SUITE 102
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City | CINCINNATI
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State | OH
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Zip | 45238-2269
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Country | US
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Telephone | 513-661-4100
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Fax | 513-661-4101
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Provider Business Mailing Address
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Address Line | 3012 GLENMORE AVE SUITE 102
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City | CINCINNATI
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State | OH
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Zip | 45238-2269
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Country | US
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Telephone | 513-661-4100
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Fax | 513-661-4101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK ALLEN STIEBY
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Credential | D.P.M.
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Telephone | 513-661-4100
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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 | 36-00-3054
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License Number State | OH
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