MEDICARE: CHRISTINE E WEIKERT DPM 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	332B00000X	Durable Medical Equipment & Medical Supplies	SC004314-L	PA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	SC004314-L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC1633	OTHER	PA	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	130724	OTHER	PA	HEALTH AMERICA
3	958D	OTHER	PA	UPMC
4	7237	OTHER	PA	GEISINGER
5	02827700	OTHER	PA	CAPITAL BLUE CROSS
6	NI146621	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1457385395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINE E WEIKERT DPM PC

Provider Business Mailing Address
First Line	:	1333 S ALLEN ST
Second Line	:	SUITE 4
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-5944
Country	:	US
Telephone Number	:	814-231-0451
Fax Number	:	814-231-1817

Provider Business Practice Location Address
First Line	:	1333 S ALLEN ST
Second Line	:	SUITE 4
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-5944
Country	:	US
Telephone Number	:	814-231-0451
Fax Number	:	814-231-1817

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTINE E WEIKERT
Credential	:	DPM
Telephone Number	:	814-231-0451

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	12/01/2011

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