Provider Demographics
NPI:1942230115
Name:NEMET, EDWARD J (DPM)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:NEMET
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 1:9630 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:234-212-9940
Mailing Address - Fax:234-212-9943
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:234-212-9940
Practice Address - Fax:234-212-9943
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003240213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2324952Medicaid
OHNE4073716Medicare PIN