Individual
KENNETH EMCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
8175 MARKET ST, BOARDMAN, OH 44512-6244
(330) 629-8800
(330) 758-4914
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 626-6161
(419) 502-3511
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
290
WV
213E00000X
Podiatrist
Primary
36-00-2828
OH
213E00000X
Podiatrist
SC-00-3885
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000458128
HIGHMARK
—
05
—
01496133
—
PA
05
—
0940558
—
OH
01
—
1054389
WORKERS COMP
WV
01
—
4524850
AETNA
—
05
—
6420070-0099858-000
—
WV
Enumeration date
07/01/2005
Last updated
02/21/2019
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