Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC002502L | PA |
Y | 222Z00000X | Podiatrist | SC002502L | PA |
NPI | 1053304360 |
---|---|
Provider Name | Dr. Anthony Charles Sottile |
First Address | Columbia, PA 17512-1220 |
Second Address | Columbia, PA 17512-1220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01541001 | BL/CR (01) | |
12491 | H/AM/H/ASSUR (01) | |
992157 | KEYSTONE (01) | |
T28561 | (02) |