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General NPI Number Information
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NPI Number | 1831311174
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Entity Type | Organization
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Legal Business Name | PERRYSBURG PODIATRY LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 5705 MONCLOVA RD SUITE 202
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City | MAUMEE
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State | OH
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Zip | 43537-1877
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Country | US
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Telephone | 419-893-3711
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Fax | 419-874-2013
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Provider Business Mailing Address
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Address Line | 5705 MONCLOVA RD SUITE 202
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City | MAUMEE
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State | OH
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Zip | 43537-1877
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Country | US
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Telephone | 419-893-3711
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Fax | 419-874-2013
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Authorized Official
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Title or Position | OWNER-PRESIDENT
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Name | EDWARD FRANCIS SZABO
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Credential | D.P.M.
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Telephone | 419-874-9702
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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 | 36-003362
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License Number State | OH
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