Provider Demographics
NPI:1649242629
Name:TRATTNER, ERIC D (DPM)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:TRATTNER
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:PO BOX 39662
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44139-0662
Mailing Address - Country:US
Mailing Address - Phone:330-405-3301
Mailing Address - Fax:330-405-3315
Practice Address - Street 1:8900 DARROW RD STE H110
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6801
Practice Address - Country:US
Practice Address - Phone:330-405-3301
Practice Address - Fax:330-405-3315
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZO589213E00000X
FLPO3222213E00000X
OH36002488213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0706785Medicaid
OHSP04441Medicare PIN
OH2521930002Medicare NSC
OH0706785Medicaid