MEDICARE: ANKLE AND FOOT CARE CENTERS

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	5504	OTHER	OH	RAILROAD MEDICARE

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

General Provider Information

NPI Number	:	1316989775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANKLE AND FOOT CARE CENTERS

Provider Business Mailing Address
First Line	:	2380 SOUTHEAST BLVD
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-3476
Country	:	US
Telephone Number	:	330-337-8870
Fax Number	:

Provider Business Practice Location Address
First Line	:	2380 SOUTHEAST BLVD
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-3476
Country	:	US
Telephone Number	:	330-337-8870
Fax Number	:

Authorized Official
Title or Position	:	DPM
Name	:	LAWRENCE DIDOMENICO
Credential	:	DPM
Telephone Number	:	330-629-8800

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	11/01/2007

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Directions to “ANKLE AND FOOT CARE CENTERS ” Practice Location

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