James Edwin Prommersberger
Podiatrist Foot & Ankle Surgery
940 Windham Ct Suite #3
Boardman
, Ohio 44512-5060
James Edwin Prommersberger
Podiatrist Foot & Ankle Surgery
940 Windham Ct Suite #3
Boardman
, Ohio 44512-5060
(330) 726-3856
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About
Features
Specialties
- Podiatrist
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- James Edwin Prommersberger
- 940 Windham Ct Suite #3
- Boardman, OH
- Zip : 44512-5060
- Fax : (330) 726-3856
- Phone : (330) 726-3348
Second Address
- James Edwin Prommersberger
- 940 Windham Ct Suite #3
- Boardman, OH
- Zip : 44512-5060
- Fax : (330) 726-3856
- Phone : (330) 726-3348
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 36-00-2619 | OH |
| Y | 222Z00000X | Podiatrist | 36-00-2619 | OH |
| N | 213ES0103X | Foot & Ankle Surgery | 36-00-2619 | OH |
National Provider Identifier
| NPI | 1073584686 |
|---|---|
| Provider Name | James Edwin Prommersberger |
| First Address | Boardman, OH 44512-5060 |
| Second Address | Boardman, OH 44512-5060 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/01/2006 |
| Last Update Date | 02/06/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000177949 | ANTHEM (01) | OH |
| 000601363 | BLUE SHIELD MOUNTAIN STATE (01) | WV |
| 0099572000 | MEDICAID WV (01) | WV |
| 0774194 | (05) | OH |
| P00199462 | MEDICARE TRAVELERS (01) | OH |
| T90004 | (02) | OH |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.