MEDICARE: MJ6 ENTERPRISES 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
1	213E00000X	Podiatrist	SC004446R	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1114120870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MJ6 ENTERPRISES PC

Provider Business Mailing Address
First Line	:	51 GOLDFINCH CIR
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-1001
Country	:	US
Telephone Number	:	484-824-2405
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 RED HILL CT
Second Line	:
City	:	NEWPORT
State	:	PA
Zip	:	17074-8706
Country	:	US
Telephone Number	:	717-567-9100
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK E WINTERSTEEN
Credential	:	DPM
Telephone Number	:	717-567-9100

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	06/07/2010

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1871553842 — ALBERT J KNOUSE JR. MD
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Directions to “MJ6 ENTERPRISES PC ” Practice Location

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