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General NPI Number Information
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NPI Number | 1336236801
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Entity Type | Organization
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Legal Business Name | GREGORY S. MARKANTONE DPM PC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 3863 ROUTE 30 EAST
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City | LATROBE
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State | PA
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Zip | 15650
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Country | US
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Telephone | 724-539-7050
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Fax |
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Provider Business Mailing Address
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Address Line | 3863 ROUTE 30 EAST
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City | LATROBE
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State | PA
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Zip | 15650
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Country | US
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Telephone | 724-539-7050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREGORY S MARKANTONE
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Credential | DPM
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Telephone | 724-539-7050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC003702R
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License Number State | PA
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