MEDICARE: DR. SHARON L. GRISSINGER DPM

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	SC-003235-L	PA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	SC-003235-L	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	:	1598763559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON L. GRISSINGER DPM

Provider Business Mailing Address
First Line	:	112 FRANK ST
Second Line	:
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-1422
Country	:	US
Telephone Number	:	717-653-6350
Fax Number	:	717-653-8044

Provider Business Practice Location Address
First Line	:	112 FRANK ST
Second Line	:
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-1422
Country	:	US
Telephone Number	:	717-653-6350
Fax Number	:	717-653-8044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	12/02/2010

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