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Individual
SAMUEL FERGUSON QUARTEY
Active
Individual
SAMUEL FERGUSON QUARTEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002081L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060592000
KEYSTONE EAST
PA
01
—
0060692000
KEYSTONE 65
PA
05
—
0540237
—
PA
01
—
095915
BCBS
PA
Enumeration date
02/28/2006
Last updated
11/19/2010
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