1831173897 NPI number — DR. CHRISTINE ELIZABETH WEIKERT D.P.M.

Table of content: DR. CHRISTINE ELIZABETH WEIKERT D.P.M. (NPI 1831173897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831173897 NPI number — DR. CHRISTINE ELIZABETH WEIKERT D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEIKERT
Provider First Name:
CHRISTINE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831173897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1333 S ALLEN ST
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
STATE COLLEGE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16801-5944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-231-0451
Provider Business Mailing Address Fax Number:
814-231-1817

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1333 S ALLEN ST
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-5944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-231-0451
Provider Business Practice Location Address Fax Number:
814-231-1817
Provider Enumeration Date:
12/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  SC004314L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0641728 . This is a "KEYSTONE H PLAN CENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017462270005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 52041 . This is a "GEISINGER PROV NO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01994501 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: WE641728 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000094377 . This is a "THREE RIVERS PROV NO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 130727 . This is a "HEALTH AMERICA PROV NO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 206690 . This is a "UPMC PROV NO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 480031519 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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