Individual
JOSEPH GERARD PROEBSTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
8023 RITCHIE HWY, PASADENA, MD 21122-7107
(410) 761-3338
(410) 761-0265
Mailing address
8023 RITCHIE HWY, PASADENA, MD 21122-7107
(410) 761-3338
(410) 761-0265
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01059
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359218900
—
MD
01
—
455037358
TRICARE
MD
01
—
AC99
BLUE CHOICE
MD
01
—
CD0XJG
BLUE CROSS BLUE SHIELD
MD
01
—
DS9585
RAILROAD MEDICARE
MD
Enumeration date
07/13/2005
Last updated
03/30/2021
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