MEDICARE: DR. HOWARD MYLES KIMMEL 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	36002841	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480026423	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1124055918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD MYLES KIMMEL DPM

Provider Business Mailing Address
First Line	:	14401 SNOW RD
Second Line	:
City	:	BROOKPARK
State	:	OH
Zip	:	44142-2583
Country	:	US
Telephone Number	:	216-267-0304
Fax Number	:	216-267-1077

Provider Business Practice Location Address
First Line	:	14401 SNOW RD
Second Line	:
City	:	BROOKPARK
State	:	OH
Zip	:	44142-2583
Country	:	US
Telephone Number	:	216-267-0304
Fax Number	:	216-267-1077

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	02/05/2020

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