Healthcare Provider Details

I. General information

NPI: 1760631642
Provider Name (Legal Business Name): MICHAEL ESKAROUS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PENNS TRL
NEWTOWN PA
18940-1892
US

IV. Provider business mailing address

8470 LIMEKILN PIKE APT 406
WYNCOTE PA
19095-2701
US

V. Phone/Fax

Practice location:
  • Phone: 608-213-8363
  • Fax:
Mailing address:
  • Phone: 608-213-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4996
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number979-025
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC006093
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: