is a Podiatrist in Philadelphia, Pennsylvania. practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for is 1174733026. The last update date is .
's current location address is 2780 W Country Club Rd, Philadelphia, Pennsylvania. You can contact this provider via phone number 2158790277 and fax number 2158798151. The mailing address for is 2780 W Country Club Rd, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 2780 W Country Club Rd, Philadelphia, Pennsylvania |
Phone Number | 2158790277 |
Fax Number | 2158798151 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1174733026 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 2780 W Country Club Rd |
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City | Philadelphia |
State | Pennsylvania (PA) |
Post Code | 191312813 |
Phone Number | 2158790277 |
Fax Number | 2158798151 |
Provider's Primary Taxonomy Detail
Speciality | Podiatrist |
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Taxonomy | 213E00000X |
Licence No | SC002829L |
Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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2412760000 | PA | INDEPENDENCE BLUE CROSS |
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