MEDICARE: DR. MARTIN NICHOLAS LESNAK D.P.M.

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	3390	OH
2	213ES0131X	Foot Surgery Podiatrist	3390	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

General Provider Information

NPI Number	:	1659359529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN NICHOLAS LESNAK D.P.M.

Provider Business Mailing Address
First Line	:	2320 UNIVERSITY DR EAST
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-9173
Country	:	US
Telephone Number	:	419-433-4800
Fax Number	:	419-433-4833

Provider Business Practice Location Address
First Line	:	2320 UNIVERSITY DR EAST
Second Line	:	SUITE A
City	:	HURON
State	:	OH
Zip	:	44839
Country	:	US
Telephone Number	:	419-433-4800
Fax Number	:	419-433-4833

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

Provider Enumeration Date	:	01/02/2006
Last Update Date	:	12/08/2014

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Directions to “ DR. MARTIN NICHOLAS LESNAK D.P.M.” Practice Location

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