Organization
MORTEZA MIRHAIDARI D P M
Active
Other names
Dover Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MORTEZA MIRHAIDARI D.P.M. (OWNER)
(330) 364-8884
Entity
Organization
Contact information
Practice address
152 NORTH BROADWAY, SUITE 100, NEW PHILADELPHIA, OH 44663
(330) 364-8884
Mailing address
152 NORTH BROADWAY, SUITE 100, NEW PHILADELPHIA, OH 44663
(330) 364-8884
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002348M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0624793
—
OH
01
—
CL5308
RAILROAD MEDICARE
OH
Enumeration date
11/05/2007
Last updated
01/20/2012
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