MEDICARE: MARK S SMESKO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	353	WV
2	213E00000X	Podiatrist	SC-00-4569	PA
3	213E00000X	Podiatrist	36-00-2979	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043217813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK S SMESKO DPM

Provider Business Mailing Address
First Line	:	PO BOX 378
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44871-0378
Country	:	US
Telephone Number	:	419-626-6161
Fax Number	:	419-502-3511

Provider Business Practice Location Address
First Line	:	136 N MARKET ST
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-2019
Country	:	US
Telephone Number	:	330-426-1828
Fax Number	:	330-426-1839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	02/21/2019

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Directions to “ MARK S SMESKO DPM” Practice Location

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