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

Providence Medical Group

Organization Podiatrist · NPI 1811304595

Providence Medical Group is a Podiatrist in Moraine, Ohio. Licensed in Ohio. Registered with an NPI since 2014.

Licensed in
OH
In the registry since
2014
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Practice location Address checks out

2912 Springboro Rd Ste 201
Moraine, OH 45439-1674
Phone: (937) 297-8999
Fax: (937) 297-4852
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 36.003657 (OH)

Record details

NPI number1811304595
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Podiatry
Authorized official Susan Becker — Chief Operating Officer · (937) 297-8999
NPI enumeratedJuly 15, 2014
Last updated in NPPESOctober 28, 2014
Mailing address2912 Springboro Rd, Suite 201, Moraine, OH 45439-1674