Provider Demographics
NPI:1235237389
Name:EASTSIDE FOOT & ANKLE CENTER
Entity Type:Organization
Organization Name:EASTSIDE FOOT & ANKLE CENTER
Other - Org Name:GROVEPORT FOOT & ANDLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SZAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-866-2477
Mailing Address - Street 1:6002 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213
Mailing Address - Country:US
Mailing Address - Phone:614-866-2477
Mailing Address - Fax:614-866-2494
Practice Address - Street 1:6002 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:614-866-2477
Practice Address - Fax:614-866-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2700070OtherUHC
0448963OtherAETNA
1146OtherNATIONWIDE
000000119119OtherANTHEM
OH0614848Medicaid
OH12905OtherCARESOURCE
73297OtherHEALTH PARTNERS
CM1661OtherRR MCR
73297OtherHEALTH PARTNERS
2700070OtherUHC
OH12905OtherCARESOURCE
2700070OtherUHC
T80718Medicare UPIN