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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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