Provider Demographics
NPI:1033117916
Name:WARNER, DAVID H (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:WARNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2013
Mailing Address - Country:US
Mailing Address - Phone:610-759-4555
Mailing Address - Fax:610-759-2966
Practice Address - Street 1:198 S GREEN ST
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-2013
Practice Address - Country:US
Practice Address - Phone:610-759-4555
Practice Address - Fax:610-759-2966
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002515L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01579281Medicaid
PA01824801OtherCAPITAL BC PROVIDER #
PA0664930001Medicare NSC
PA01824801OtherCAPITAL BC PROVIDER #
PAT82285Medicare UPIN