Provider Demographics
NPI:1407852767
Name:KUSHNER, DONALD (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:KUSHNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 E BLVD
Mailing Address - Street 2:CLEVELAND DEPT OF VETERANS AFFAIRS MEDICAL CENTER
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-707-5970
Practice Address - Street 1:10701 E BLVD
Practice Address - Street 2:CLEVELAND DEPT OF VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-707-5970
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36 002514213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0707720Medicaid
OHT11124Medicare UPIN
OHKU0620712Medicare ID - Type Unspecified