Provider Demographics
NPI: | 1538327416 |
---|---|
Name: | SOLIMEO, MAGGIE UMERES (DPM) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | MAGGIE |
Middle Name: | UMERES |
Last Name: | SOLIMEO |
Suffix: | |
Gender: | F |
Credentials: | DPM |
Other - Prefix: | DR |
Other - First Name: | MAGGIE |
Other - Middle Name: | |
Other - Last Name: | UMERES |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | DPM |
Mailing Address - Street 1: | 924 MAIN ST |
Mailing Address - Street 2: | |
Mailing Address - City: | HELLERTOWN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18055-1525 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 610-838-7942 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 924 MAIN ST |
Practice Address - Street 2: | |
Practice Address - City: | HELLERTOWN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18055-1525 |
Practice Address - Country: | US |
Practice Address - Phone: | 610-838-7942 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-05-28 |
Last Update Date: | 2014-02-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | SC006006 | 213E00000X, 213ES0103X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 12151672 | Other | CAQH |
PA | 5408981 | Other | CIGNA |
PA | 181929 | Medicare PIN |