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 1992977987

Grand Lake Podiatry Inc provides Foot & Ankle Surgery Podiatrist services in Van Wert, 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

140 Fox Rd STE104
Van Wert, OH 45891-2475 Not confirmed with CMS for 15 years — call before visiting
Phone: (419) 586-7874
Fax: (419) 586-2776
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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 number1992977987
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Benjamin-Swonger — Podiatrist/Owner-President · (419) 586-7874
NPI enumeratedMarch 31, 2008
Last updated in NPPESFebruary 1, 2011
Mailing address1222 Irmscher Blvd, Celina, OH 45822-8305

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