Provider Demographics
NPI:1457385395
Name:CHRISTINE E WEIKERT DPM PC
Entity type:Organization
Organization Name:CHRISTINE E WEIKERT DPM PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEIKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:814-231-0451
Mailing Address - Street 1:1333 S ALLEN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5944
Mailing Address - Country:US
Mailing Address - Phone:814-231-0451
Mailing Address - Fax:814-231-1817
Practice Address - Street 1:1333 S ALLEN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5944
Practice Address - Country:US
Practice Address - Phone:814-231-0451
Practice Address - Fax:814-231-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004314-L332B00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADC1633OtherMEDICARE RR
PA130724OtherHEALTH AMERICA
PA958DOtherUPMC
PA7237OtherGEISINGER
PA02827700OtherCAPITAL BLUE CROSS
PANI146621OtherHIGHMARK
PA958DOtherUPMC
PADC1633OtherMEDICARE RR