MEDICARE: DR. MICHAEL P. REGAN 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	36002164R	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4280581	OTHER	OH	MEDICARE PTAN NUMBER

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	:	1699767269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL P. REGAN DPM

Provider Business Mailing Address
First Line	:	PO BOX 1022
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45401-1022
Country	:	US
Telephone Number	:	937-221-8555
Fax Number	:	937-567-4170

Provider Business Practice Location Address
First Line	:	425 W GRAND AVE STE 3002
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-4722
Country	:	US
Telephone Number	:	937-723-4231
Fax Number	:	937-734-4170

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	06/15/2023

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Directions to “ DR. MICHAEL P. REGAN DPM” Practice Location

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