Organization
BRIAN CRISPELL D.P.M
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN CRISPELL D.P.M (OWNER)
(215) 512-0488
Entity
Organization
Contact information
Practice address
1078 W BALTIMORE PIKE, RIDDLE HCC 1 SUITE 209, MEDIA, PA 19063-5105
(215) 512-0488
Mailing address
2301 GREEN ST, APT 8, PHILADELPHIA, PA 19130-3143
(215) 512-0488
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC005698
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
329832
MEDICARE PTAN
PA
Enumeration date
12/05/2013
Last updated
03/05/2014
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