Provider Demographics
NPI:1760809990
Name:GRANDINETTI, LOUIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:GRANDINETTI
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 1:3333 MASSILLON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5992
Mailing Address - Country:US
Mailing Address - Phone:330-899-9160
Mailing Address - Fax:330-899-9170
Practice Address - Street 1:3333 MASSILLON RD STE 203
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5992
Practice Address - Country:US
Practice Address - Phone:330-899-9160
Practice Address - Fax:330-899-9170
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000000000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery