Organization
CENTRAL PA PODIATRY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD E MRDJENOVICH DPM (PRESIDENT)
(814) 946-1075
Entity
Organization
Contact information
Practice address
2727 BEALE AVE, SUITE A, ALTOONA, PA 16601-1705
(814) 946-1075
(814) 946-4076
Mailing address
2727 BEALE AVE, SUITE A, ALTOONA, PA 16601-1705
(814) 946-1075
(814) 946-4076
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
213ER0200X
Radiology Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0857830000
INDEPENDENCE PPO BLUE GRP
—
01
—
1024437
GATEWAY GROUP
PA
01
—
1115690001
DME GROUP
PA
01
—
826758
BLUE SHIELD GROUP
PA
01
—
CC2226
RR MEDICARE
—
01
—
H26758
PREFERRED HEALTHCARE
—
Enumeration date
01/11/2006
Last updated
05/05/2011
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