John Michael Fanelly, DPM Valid NPI

Individual provider · Podiatrist · Philadelphia, PA

NPI

1164403697

Type

Individual (Type 1)

Primary specialty

Podiatrist

Specialty group

Podiatric Medicine & Surgery Service Providers

Taxonomy code

213E00000X

License number

SC002579L (PA)

Sex

Male

Sole proprietor

Yes

Enumerated

2005-11-10

Last updated

2009-12-07