Provider Demographics
NPI:1316270663
Name:ADVANCED FOOT & ANKLE ASSOCIATES
Entity type:Organization
Organization Name:ADVANCED FOOT & ANKLE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-283-5030
Mailing Address - Street 1:3461 WARRENSVILLE CENTER RD
Mailing Address - Street 2:201
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5260
Mailing Address - Country:US
Mailing Address - Phone:216-283-5030
Mailing Address - Fax:216-283-5037
Practice Address - Street 1:3461 WARRENSVILLE CENTER RD
Practice Address - Street 2:201
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5260
Practice Address - Country:US
Practice Address - Phone:216-283-5030
Practice Address - Fax:216-283-5037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003401213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty