Provider Demographics
NPI:1750361689
Name:GIEGERICH, PAUL RAYMOND (DPM)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:RAYMOND
Last Name:GIEGERICH
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 1:11210 ODELL FARMS CT
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-4108
Mailing Address - Country:US
Mailing Address - Phone:301-595-0564
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 402
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-726-1800
Practice Address - Fax:202-726-9661
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO375213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC270238000Medicaid
DC010200890Medicaid
DC023815900Medicaid
DC418042Medicare ID - Type UnspecifiedMEDICARE
DC270238000Medicaid