Provider Demographics
NPI:1659490894
Name:BAY CITY ASSOCIATES IN PODIATRY INC
Entity Type:Organization
Organization Name:BAY CITY ASSOCIATES IN PODIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:814-864-2360
Mailing Address - Street 1:3850 WALKER BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1627
Mailing Address - Country:US
Mailing Address - Phone:814-864-2360
Mailing Address - Fax:814-864-2383
Practice Address - Street 1:3850 WALKER BLVD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1627
Practice Address - Country:US
Practice Address - Phone:814-864-2360
Practice Address - Fax:814-864-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA213E50103X213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA443626OtherMEDICARE
PA208378OtherUPMC
PA1500186OtherGATEWAY ASSURED
PA4099240OtherAETNA PPO
PA10937716OtherUNITED HEALTHCARE
PA315569OtherHEALTH AMERICA
PA748412OtherAETNA HMO
PA64728OtherUNISON ADV
PA443626OtherHIGHMARK
PA4723300001Medicare NSC
PA4099240OtherAETNA PPO