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NPI Code Detail

MEDICARE: DR. BRUCE G GREENFIELD DPM PC

MEDICARE: DR. BRUCE G GREENFIELD DPM PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic SupplierSCOO2317-1PA
2213ES0103XFoot & Ankle Surgery PodiatristSC0023171-1PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053641431
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. BRUCE G GREENFIELD DPM PC
Provider Business Mailing Address
First Line : 2800 W TOWNSHIP LINE RD
Second Line :
City : HAVERTOWN
State : PA
Zip : 19083-5215
Country : US
Telephone Number : 610-449-3344
Fax Number : 610-789-6753
Provider Business Practice Location Address
First Line : 2800 W TOWNSHIP LINE RD
Second Line :
City : HAVERTOWN
State : PA
Zip : 19083-5215
Country : US
Telephone Number : 610-449-3344
Fax Number : 610-789-6753
Authorized Official
Title or Position : OWNER
Name : DR. BRUCE G GREENFIELD
Credential : DOM
Telephone Number : 610-449-3344
Provider Enumeration Date : 01/06/2010
Last Update Date : 02/28/2017

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