Organization
MIDWEST FOOTCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS M VICHINSKY D.P.M. (PRESIDENT)
(937) 642-9936
Entity
Organization
Contact information
Practice address
875 E COLUMBUS ST, KENTON, OH 43326-2601
(419) 675-3668
(419) 675-2237
Mailing address
245 STOCKSDALE DR, MARYSVILLE, OH 43040-1563
(937) 642-9936
(937) 642-5537
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36-00-1774-V
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2457934
—
OH
Enumeration date
07/24/2009
Last updated
08/12/2009
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