Ohio Podiatric Physicians and Surgeons Group, LLC

NPI #1508264680 in Maumee, Ohio

Provider Information

NPI Number: 1508264680
Entity Type: Organization
Organization Name: Ohio Podiatric Physicians and Surgeons Group, LLC
Primary Specialty: Podiatrist - Primary Podiatric Medicine
Enumeration Date: Dec 5, 2014
Last Updated: Dec 5, 2014

Practice Location

Address: 5757 MONCLOVA RD
Address 2: SUITE 5
City: Maumee
State: Ohio
ZIP Code: 43537-1863
Phone: (419) 893-5757

Authorized Official

Name: BEAU GREGORY BORTEL, DPM
Title: PHYSICIAN
Phone: (419) 893-5757

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery	213ES0103X
Podiatrist - Foot Surgery — Foot Surgery	213ES0131X
Podiatrist - Primary Podiatric Medicine — Primary Podiatric Medicine	213EP1101X	Primary

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