MEDICARE: MLG PODIATRY INC

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

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
2	546370	OTHER	PA	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1265468482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MLG PODIATRY INC

Provider Business Mailing Address
First Line	:	730 BROWNSVILLE RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15210-2300
Country	:	US
Telephone Number	:	412-381-4830
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 BROWNSVILLE RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15210-2300
Country	:	US
Telephone Number	:	412-381-4830
Fax Number	:

Authorized Official
Title or Position	:	BILLING MGR
Name	:	PAM BORNSCHEUER
Credential	:
Telephone Number	:	412-381-4830

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	08/05/2008

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Directions to “MLG PODIATRY INC ” Practice Location

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