Healthcare Provider Details

I. General information

NPI: 1447682968
Provider Name (Legal Business Name): SETH EBERHARDT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6TH AVENUE & SPRUCE STREET
WEST READING PA
19611
US

IV. Provider business mailing address

50 COMMERCE DR
WYOMISSING PA
19610-3335
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-4908
  • Fax:
Mailing address:
  • Phone: 610-372-8044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC006462
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: