MEDICARE: RICHARD R NADALIN JR 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	36001683	OH

General Provider Information

NPI Number	:	1710156542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD R NADALIN JR DPM

Provider Business Mailing Address
First Line	:	PO BOX 30977
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-0977
Country	:	US
Telephone Number	:	614-428-7701
Fax Number	:

Provider Business Practice Location Address
First Line	:	453 WATERBURY CT
Second Line	:	SUITE 200
City	:	GAHANNA
State	:	OH
Zip	:	43230-5309
Country	:	US
Telephone Number	:	614-428-7701
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD R NADALIN
Credential	:	DPM
Telephone Number	:	614-428-7701

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	02/26/2008

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