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NPI Code Detail

MEDICARE: DR. GARY A RAYMOND DPM

MEDICARE: DR. GARY A RAYMOND 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
1213ES0131XFoot Surgery PodiatristSC002487LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2399941327OTHERPAGEISINGER
399382OTHERPAHEALTH AMERICA
4251753069OTHERPAAETNA
51019736OTHERPAGATEWAY
6RA430959OTHERPABC/BS

General Provider Information

NPI Number : 1942204367
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY A RAYMOND DPM
Provider Business Mailing Address
First Line : 711 LOGAN BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4165
Country : US
Telephone Number : 814-943-3668
Fax Number : 814-942-7635
Provider Business Practice Location Address
First Line : 711 LOGAN BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4165
Country : US
Telephone Number : 814-943-3668
Fax Number : 814-942-7635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 09/26/2022

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