Provider Demographics
NPI:1538270715
Name:JOHN M CUFFARI DPM INC
Entity type:Organization
Organization Name:JOHN M CUFFARI DPM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARIO
Authorized Official - Last Name:CUFFARI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-333-7300
Mailing Address - Street 1:21992 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3333
Mailing Address - Country:US
Mailing Address - Phone:440-333-7300
Mailing Address - Fax:440-333-7308
Practice Address - Street 1:21992 LORAIN RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3333
Practice Address - Country:US
Practice Address - Phone:440-333-7300
Practice Address - Fax:440-333-7308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002362C213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0671009Medicaid
000000251058OtherANTHEM
281462385-013OtherMEDICAL MUTUAL
SPO3321Medicare PIN