Provider Demographics
NPI:1114120870
Name:MJ6 ENTERPRISES PC
Entity Type:Organization
Organization Name:MJ6 ENTERPRISES PC
Other - Org Name:WINTERSTEEN FOOT AND ANKLE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:WINTERSTEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-567-9100
Mailing Address - Street 1:51 GOLDFINCH CIR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1001
Mailing Address - Country:US
Mailing Address - Phone:484-824-2405
Mailing Address - Fax:
Practice Address - Street 1:36 RED HILL CT
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-8706
Practice Address - Country:US
Practice Address - Phone:717-567-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004446R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019879850002Medicaid
PA1019879850002Medicaid
PA5916000001Medicare NSC
PA112504Medicare PIN