Provider Demographics
NPI:1609827880
Name:ENGEL, ERIN BETH (DPM)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:BETH
Last Name:ENGEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 STUDEBAKER RD
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-8535
Mailing Address - Country:US
Mailing Address - Phone:937-478-3855
Mailing Address - Fax:
Practice Address - Street 1:7200 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-8535
Practice Address - Country:US
Practice Address - Phone:937-478-3855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003424213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2658717Medicaid
OHH114420Medicare PIN