Provider Demographics
NPI:1265621627
Name:DR. ANTHONY E. NUMRICH PS
Entity type:Organization
Organization Name:DR. ANTHONY E. NUMRICH PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:E
Authorized Official - Last Name:NUMRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:513-829-6080
Mailing Address - Street 1:511 NILLES RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2634
Mailing Address - Country:US
Mailing Address - Phone:513-829-6080
Mailing Address - Fax:
Practice Address - Street 1:511 NILLES RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2634
Practice Address - Country:US
Practice Address - Phone:513-829-6080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1962-OH213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0436308Medicaid
OH000000036074OtherANTHEM
OH0479092Medicare PIN