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General NPI Number Information
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NPI Number | 1851056204
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Entity Type | Organization
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Legal Business Name | NORTH CANTON PODIATRY INC
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 8328 CLEVELAND AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-4820
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Country | US
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Telephone | 330-494-4949
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Fax |
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Provider Business Mailing Address
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Address Line | 8328 CLEVELAND AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-4820
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Country | US
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Telephone | 330-494-4949
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PRIYANKA J MUDE
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Credential | DPM
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Telephone | 330-494-4949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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