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Individual
LARRY CAMPOLI
Active
Individual
LARRY CAMPOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC-002928-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010721760004
—
PA
01
—
1362204
UNITED MINE WORKERS AMER
PA
01
—
13943
ELDERHEALTH
PA
05
—
1504983
—
PA
01
—
183240
BLUE CROSS BLUE SHIELD
PA
05
—
88375
—
PA
Enumeration date
09/06/2006
Last updated
07/09/2007
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