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Contact Information

BAYSIDE PODIATRY PA
927 E COLORADO BLVD
SPEARFISH, SD57783-2783
 Phone: 605-641-5794
 Fax: 480-393-5577
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BAYSIDE PODIATRY PA · (Female)

NPI Number 1740345057
Status Active
Credentials
Entity Individual
Enumeration date 12/27/2006
Last updated 07/08/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # PO3166
  • FL Other 65859Z BLUE CROSS
  • FL Other 5320260001 DMERC
  • FL Other P00205681 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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