MEDICARE: DR. BEVERLY JEAN GRUARIN D.P.M.

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	SC002856L	PA

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	:	1912122920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEVERLY JEAN GRUARIN D.P.M.

Provider Business Mailing Address
First Line	:	4732 LIBERTY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-2051
Country	:	US
Telephone Number	:	412-681-8840
Fax Number	:	412-681-9073

Provider Business Practice Location Address
First Line	:	4732 LIBERTY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-2051
Country	:	US
Telephone Number	:	412-681-8840
Fax Number	:	412-681-9073

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	02/28/2008

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Directions to “ DR. BEVERLY JEAN GRUARIN D.P.M.” Practice Location

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