Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC004446R | PA |
N | 222Z00000X | Podiatrist | SC004446R | PA |
Y | 213EP1101X | Primary Podiatric Medicine | SC004446R | PA |
N | 213ES0131X | Foot Surgery | SC004446R | PA |
NPI | 1578530671 |
---|---|
Provider Name | Dr. Mark Edward Wintersteen |
First Address | Newport, PA 17074-8706 |
Second Address | Newport, PA 17074-8706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 18/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019879850002 | (05) | PA |
U73378 | (02) | PA |