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Individual
MICHAEL CRAIG PENCHUK
Active
Individual
MICHAEL CRAIG PENCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
005080
NY
213E00000X
Podiatrist
25MD00225600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6200811
GHI
—
01
—
P1100931
OXFORD HEALTH PLANS
—
Enumeration date
09/30/2006
Last updated
07/08/2007
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