MEDICARE: STEVEN B GROSSMAN

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	36001586	OH

General Provider Information

NPI Number	:	1245407923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN B GROSSMAN

Provider Business Mailing Address
First Line	:	6200 PLEASANT AVE
Second Line	:	STE 3
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-4670
Country	:	US
Telephone Number	:	513-829-9333
Fax Number	:

Provider Business Practice Location Address
First Line	:	4068 GANTZ RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-4816
Country	:	US
Telephone Number	:	614-539-0200
Fax Number	:	614-317-7392

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN B GROSSMAN
Credential	:	DPM
Telephone Number	:	614-539-0200

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	02/05/2020

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