Provider Demographics
NPI:1194792721
Name:CAO, MINH P (DPM)
Entity type:Individual
Prefix:DR
First Name:MINH
Middle Name:P
Last Name:CAO
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:571 BERLIN CROSS KEYS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-9550
Mailing Address - Country:US
Mailing Address - Phone:856-875-9553
Mailing Address - Fax:856-875-9443
Practice Address - Street 1:571 BERLIN CROSS KEYS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-9550
Practice Address - Country:US
Practice Address - Phone:856-875-9553
Practice Address - Fax:856-875-9443
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2020-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00276000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0026247Medicaid
NJ5563420001Medicare NSC
NJU99593Medicare UPIN
NJ078092Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER