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AUSTIN LANE SEDICUM III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1040 S WEST END BLVD, QUAKERTOWN, PA 18951
(215) 529-6511
(215) 529-6512
Mailing address
1040 S WEST END BLVD, QUAKERTOWN, PA 18951
(215) 529-6511
(215) 529-6512

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC005511
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
063479Q2K
MEDICARE INDIVIDUAL
01
063480
MEDICARE PIN
01
1417165
BS INDIVIDUAL
01
1418639
BS GROUP
01
2103588000
KEYSTONE INDIVIDUAL GROUP
01
2105345000
KEYSTONE GROUP
01
2941264
AETNA HMO PIN
01
50010317
CAPITAL GROUP
01
50016192
CAPITAL INDIVIDUAL
01
7802379
AETNA PPO PIN
Enumeration date
11/30/2006
Last updated
03/07/2023
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