1356387625 NPI number — DR. STEVEN MICHAEL REMUS DPM

Table of content: DR. STEVEN MICHAEL REMUS DPM (NPI 1356387625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356387625 NPI number — DR. STEVEN MICHAEL REMUS DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REMUS
Provider First Name:
STEVEN
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

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:
1356387625
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 721
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENSALEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19020-0721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-245-1818
Provider Business Mailing Address Fax Number:
215-245-9129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3554 HULMEVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
BENSALEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19020-4366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-245-1818
Provider Business Practice Location Address Fax Number:
215-245-9129
Provider Enumeration Date:
06/22/2006

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:  SC005786 , 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: 101866291 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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