Individual
SIMON B SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
327 MONTGOMERY AVE, BALA CYNWYD, PA 19004-2815
(610) 664-0848
(610) 664-7707
Mailing address
327 MONTGOMERY AVE, BALA CYNWYD, PA 19004-2815
(610) 664-0848
(610) 664-7707
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001870-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184993
BLUE SHIELD NUMBER
PA
Enumeration date
04/03/2007
Last updated
07/08/2007
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