Organization
GAITWELL ORTHOTICS AND PEDORTHICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D VEDER CO, CPED (OWNER)
(937) 456-4800
Entity
Organization
Contact information
Practice address
200 WASHINGTON JACKSON RD, STE V, EATON, OH 45320-8627
(937) 456-4800
(513) 889-1850
Mailing address
1 NORH COMMERCE PARK DRIVE, SUITE 306, CINCINNATI, OH 45215-3188
(513) 829-2217
(513) 889-1850
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
LO144
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
STRATOSE
OH
01
—
000000298877
ANTHEM BLUE CROSS
OH
05
—
200509680A
—
IN
01
—
2389384
BCMH MEDICAID
OH
05
—
2389384
—
OH
01
—
=========
HUMANA
OH
01
—
A 146591
MULTI PLAN
OH
Enumeration date
01/23/2006
Last updated
06/19/2020
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