Provider Demographics
NPI:1568460509
Name:ELIAS, BRIAN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:ELIAS
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 1:25 MONUMENT RD STE 290
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5073
Mailing Address - Country:US
Mailing Address - Phone:717-812-4090
Mailing Address - Fax:717-812-4092
Practice Address - Street 1:25 MONUMENT RD STE 290
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-812-4090
Practice Address - Fax:717-812-4092
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004352L213E00000X, 213ES0000X, 213ES0103X
PASC213ER0200X, 213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016609550007Medicaid
PA39998OtherGEISINGER
PA1931764OtherHIGHMARK BC/BS
PA308924OtherUPMC
PA5939150001Medicare NSC
PA39998OtherGEISINGER