Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grand Lake Podiatry, Inc

Organization Foot & Ankle Surgery Podiatrist · NPI 1538331525

Grand Lake Podiatry, Inc is a Foot & Ankle Surgery Podiatrist in Wapakoneta, Ohio. Licensed in Ohio. Registered with an NPI since 2008.

Licensed in
OH
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

812 Redskin Trl Ste B
Wapakoneta, OH 45895-8545
Phone: (419) 586-7874
Fax: (419) 586-2776
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 36 002772 (OH)

Record details

NPI number1538331525
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Benjamin-Swonger — Podiatrist/Owner-President · (419) 586-7874
NPI enumeratedMarch 31, 2008
Last updated in NPPESApril 18, 2008
Mailing address1222 Irmscher Blvd, Celina, OH 45822-8305