MEDICARE: DR. MICHAEL EGLOW 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	213ES0103X	Foot & Ankle Surgery Podiatrist	MD01374	NJ

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	0389260001	OTHER	NJ	DMERC

General Provider Information

NPI Number	:	1659343838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL EGLOW DPM

Provider Business Mailing Address
First Line	:	315 E NORTHFIELD RD
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-4896
Country	:	US
Telephone Number	:	973-992-0002
Fax Number	:	973-740-1413

Provider Business Practice Location Address
First Line	:	315 E NORTHFIELD RD
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-4896
Country	:	US
Telephone Number	:	973-992-0002
Fax Number	:	973-740-1413

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	02/27/2013

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