Healthcare Provider Details

I. General information

NPI: 1457601494
Provider Name (Legal Business Name): MAIKEL GRIAGES D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 OLD YORK RD
ABINGTON PA
19001-3411
US

IV. Provider business mailing address

1463 HUNTINGDON RD
ABINGTON PA
19001-2103
US

V. Phone/Fax

Practice location:
  • Phone: 551-655-7440
  • Fax:
Mailing address:
  • Phone: 551-655-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006417
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: