MEDICARE: DR. LUTHER WALTER BOND III 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	SC003825L	PA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	SCOO3825L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SCOO3825L	OTHER	PA	STATE LIC.
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902807217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUTHER WALTER BOND III DPM

Provider Business Mailing Address
First Line	:	312 E MAIN ST
Second Line	:
City	:	PEN ARGYL
State	:	PA
Zip	:	18072-1641
Country	:	US
Telephone Number	:	610-863-5214
Fax Number	:	610-863-0123

Provider Business Practice Location Address
First Line	:	312 E MAIN ST
Second Line	:
City	:	PEN ARGYL
State	:	PA
Zip	:	18072-1641
Country	:	US
Telephone Number	:	610-863-5214
Fax Number	:	610-863-0123

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	01/24/2008

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