Organization
UNIVERSITY FOOT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVENTON S WAGNER (OWNER/DPM)
(614) 488-9478
Entity
Organization
Contact information
Practice address
1208 W 5TH AVE, COLUMBUS, OH 43212-2501
(614) 488-9478
(614) 488-4836
Mailing address
1208 W 5TH AVE, COLUMBUS, OH 43212-2501
(614) 488-9478
(614) 488-4836
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002797
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0412119
—
OH
01
—
DG3159
RAILROAD MEDICARE
OH
Enumeration date
07/25/2007
Last updated
03/22/2016
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