Organization
NORTHEAST FAMILY FOOT CARE, PC
Active
Organization
NORTHEAST FAMILY FOOT CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONNA G. MYERS DPM (OWNER)
(215) 673-3200
Entity
Organization
Contact information
Practice address
9892 BUSTLETON AVE, SUITE 303, PHILADELPHIA, PA 19115-2184
(215) 673-3200
(215) 673-3884
Mailing address
9892 BUSTLETON AVE, SUITE 303, PHILADELPHIA, PA 19115-2184
(215) 673-3200
(215) 673-3884
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC004123-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018883000
INDEPENDENCE BLUE CROSS
PA
01
—
32994
HEALTH ANDSENIOR PARTNERS
PA
01
—
480034747
RAILROAD MEDICARE
PA
01
—
GOO1124200
AMERICHOICE
PA
Enumeration date
05/16/2007
Last updated
11/13/2009
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