MEDICARE: NICHOLAS ROBERT TAWEEL 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	25MD00302200	NJ
2	213E00000X	Podiatrist	SC003660L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0551628000	OTHER	PA	IBC
2	3858061	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1750336731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS ROBERT TAWEEL DPM

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST STE 520
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4430
Country	:	US
Telephone Number	:	800-321-9999
Fax Number	:	267-339-3761

Provider Business Practice Location Address
First Line	:	3300 TILLMAN DR FL 2
Second Line	:
City	:	BENSALEM
State	:	PA
Zip	:	19020-2071
Country	:	US
Telephone Number	:	267-339-3558
Fax Number	:	267-339-3763

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	03/01/2022

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