Provider Demographics
NPI:1700825080
Name:TESTA, ROBERT G (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:TESTA
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 1:29101 HEALTH CAMPUS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5270
Mailing Address - Country:US
Mailing Address - Phone:440-835-1999
Mailing Address - Fax:440-834-1996
Practice Address - Street 1:29099 HEALTH CAMPUS DR STE 290
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5280
Practice Address - Country:US
Practice Address - Phone:440-835-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-1969-T213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0520305Medicaid
OH0327598Medicaid
OHT80498Medicare UPIN
OH4259680001Medicare NSC