Individual
DR. MARK ANTHONY DI MEDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
500 SICKLERVILLE RD, WILLIAMSTOWN, NJ 08094
(856) 629-0645
(856) 629-1472
Mailing address
500 SICKLERVILLE RD, WILLIAMSTOWN, NJ 08094
(856) 629-0645
(856) 629-1472
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD001496
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1220501
—
NJ
Enumeration date
09/27/2006
Last updated
07/08/2007
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