MEDICARE: MICHAEL D WALINSKY, 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	SC003167L	PA

General Provider Information

NPI Number	:	1760668438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL D WALINSKY, DPM

Provider Business Mailing Address
First Line	:	726 YALE RD
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-2116
Country	:	US
Telephone Number	:	215-471-0433
Fax Number	:	215-471-0430

Provider Business Practice Location Address
First Line	:	4715 PINE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-1831
Country	:	US
Telephone Number	:	215-471-0433
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL DAVID WALINSKY
Credential	:	D.P.M.
Telephone Number	:	215-471-0433

Provider Enumeration Date	:	01/12/2008
Last Update Date	:	01/12/2008

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