NPI 1073510244 · live from the CMS NPI Registry
Broadway Foot Clinic Corporation
Podiatrist in Gary, IN. National Provider Identifier 1073510244, active.
NPI record
| NPI | 1073510244 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 3290 Grant St, Suite 108, Gary, IN 46408 |
| Practice phone | 219-884-7880 |
| Enumerated | July 3, 2005 |
| Last updated | August 22, 2020 |
| Authorized official | Sonny Ojikutu, Vice President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 07000445A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.