Individual
DR. ROBERT THOMAS PORTNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3691 LEE RD, STE 102, SHAKER HEIGHTS, OH 44120-5145
(216) 491-9902
(216) 491-8151
Mailing address
3691 LEE RD, STE 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
—
0752707
—
OH
01
—
480017232
RAILROAD MEDICARE
OH
Enumeration date
04/11/2006
Last updated
10/25/2007
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