Provider Demographics
NPI:1114923067
Name:EGELMAN, ERIC MILES (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MILES
Last Name:EGELMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:267-297-2455
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:825 OLD LANCASTER RD STE 140200
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3231
Practice Address - Country:US
Practice Address - Phone:610-922-2100
Practice Address - Fax:610-520-2091
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC003223L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120833269OtherGEISINGER HEALTH PLAN
PA339586OtherHEALTH AMERICA
PA02320200OtherCAPITAL BLUE CROSS
PA480027522OtherRAILROAD MEDICARE
PA001175146/0004Medicaid
PA2518246700001OtherCIGNA
PAHIGHMARK BSOther256127
PA02320200OtherKEYSTONE
PA339586OtherHEALTH AMERICA
PA001175146/0004Medicaid