PROVIDENCE MEDICAL GROUP is a podiatrist in Moraine, OH. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. PROVIDENCE MEDICAL GROUP NPI is 1811304595. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
2912 SPRINGBORO RD
SUITE 201
MORAINE, OH
ZIP 45439-674
Phone: (937) 297-8999
Fax: (937) 297-4852
The provider's authorized official is Susan Becker .
The authorized official title is Chief Operating Officer and has the following contact phone number (937) 297-8999.
The CLIA number assigned to this NPI record is 36D2072442 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 7/15/2014 and was last updated on 10/28/2014.