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NPI Code Detail

MEDICARE: ORTHOPEDIC SPECIALISTS & SPORTS MEDICINE, INC.

MEDICARE: ORTHOPEDIC SPECIALISTS & SPORTS MEDICINE, INC.
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
1174400000XSpecialist35047273OH

General Provider Information

NPI Number : 1710983200
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOPEDIC SPECIALISTS & SPORTS MEDICINE, INC.
Provider Business Mailing Address
First Line : 2750 NEWARK GRANVILLE RD
Second Line :
City : GRANVILLE
State : OH
Zip : 43023-9142
Country : US
Telephone Number : 740-788-9220
Fax Number : 740-788-9226
Provider Business Practice Location Address
First Line : 2750 NEWARK GRANVILLE RD
Second Line :
City : GRANVILLE
State : OH
Zip : 43023-9142
Country : US
Telephone Number : 740-788-9220
Fax Number : 740-788-9226
Authorized Official
Title or Position : PRESIDENT
Name : DR. EDWARD LEE WESTERHEIDE
Credential : M.D.
Telephone Number : 740-788-9220
Provider Enumeration Date : 06/21/2005
Last Update Date : 04/13/2022

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Directions to “ORTHOPEDIC SPECIALISTS & SPORTS MEDICINE, INC. ” Practice Location

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