Provider Demographics
| NPI: | 1538327416 |
|---|---|
| Name: | SOLIMEO, MAGGIE UMERES (DPM) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | MAGGIE |
| Middle Name: | UMERES |
| Last Name: | SOLIMEO |
| Suffix: | |
| Gender: | F |
| Credentials: | DPM |
| Other - Prefix: | DR |
| Other - First Name: | MAGGIE |
| Other - Middle Name: | |
| Other - Last Name: | UMERES |
| Other - Suffix: | |
| Other - Last Name Type: | Former Name |
| Other - Credentials: | DPM |
| Mailing Address - Street 1: | 924 MAIN ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HELLERTOWN |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 18055-1525 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 610-838-7942 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 924 MAIN ST |
| Practice Address - Street 2: | |
| Practice Address - City: | HELLERTOWN |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 18055-1525 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 610-838-7942 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2008-05-28 |
| Last Update Date: | 2014-02-28 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| PA | SC006006 | 213E00000X, 213ES0103X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
| No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 12151672 | Other | CAQH |
| PA | 5408981 | Other | CIGNA |
| PA | 181929 | Medicare PIN |