Provider Demographics
NPI:1326566506
Name:E J NEMET DPM LLC
Entity Type:Organization
Organization Name:E J NEMET DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TAX ID OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEMET
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-288-8831
Mailing Address - Street 1:9630 RAVENNA RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-6812
Mailing Address - Country:US
Mailing Address - Phone:216-288-8831
Mailing Address - Fax:
Practice Address - Street 1:9630 RAVENNA RD STE 300
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6812
Practice Address - Country:US
Practice Address - Phone:216-288-8831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7640310001OtherDME MAC