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Organization

MADISON LEE PODIATRY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT THOMAS PORTNOW DPM (PRESIDENT)
(216) 491-9902
Entity
Organization

Contact information

Practice address
3691 LEE RD, SUITE 102, SHAKER HEIGHTS, OH 44120-5145
(216) 491-9902
(216) 491-8151
Mailing address
3691 LEE RD, SUITE 102, SHAKER HEIGHTS, OH 44120-5145
(216) 491-9902
(216) 491-8151

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2576
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2245814
OH
Enumeration date
05/04/2006
Last updated
06/21/2010
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