Provider Demographics
NPI:1306009535
Name:DR. GARY J VOLFRE, DPM
Entity Type:Organization
Organization Name:DR. GARY J VOLFRE, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VOLFRE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-733-1546
Mailing Address - Street 1:2040 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1100
Mailing Address - Country:US
Mailing Address - Phone:330-733-1546
Mailing Address - Fax:330-733-1578
Practice Address - Street 1:2040 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1100
Practice Address - Country:US
Practice Address - Phone:330-733-1546
Practice Address - Fax:330-733-1578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002182-V213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0895020001Medicare NSC