Provider Demographics
NPI:1427069046
Name:NAGLE, CHRISTOPHER JOHN (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:NAGLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 SHENANGO VALLEY FWY
Mailing Address - Street 2:SUITE 3 NORTH
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2522
Mailing Address - Country:US
Mailing Address - Phone:724-981-6541
Mailing Address - Fax:724-982-0533
Practice Address - Street 1:1951 SHENANGO VALLEY FWY
Practice Address - Street 2:SUITE 3 NORTH
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2522
Practice Address - Country:US
Practice Address - Phone:724-981-6541
Practice Address - Fax:724-982-0533
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004060R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA058200OtherHIGHMARK
PA1496367Medicaid
PA058200OtherHIGHMARK
PAU52364Medicare UPIN