Individual
DR. EDGAR H NIETER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1661 E ATLANTIC BLVD, POMPANO BEACH, FL 33060
(954) 941-1200
(954) 942-4005
Mailing address
1661 E ATLANTIC BLVD, POMPANO BEACH, FL 33060
(954) 941-1200
(954) 942-4005
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P02132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
243967
AVMED
FL
05
—
390191200
—
FL
01
—
480014334
RAILROAD MEDICARE
FL
01
—
65239
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/27/2006
Last updated
05/08/2008
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