Provider Demographics
NPI:1588766141
Name:SOLAR, JOHN (DPM)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SOLAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1426
Mailing Address - Country:US
Mailing Address - Phone:610-337-3322
Mailing Address - Fax:610-337-2582
Practice Address - Street 1:491 ALLENDALE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1426
Practice Address - Country:US
Practice Address - Phone:610-337-3322
Practice Address - Fax:610-337-2582
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC002501L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0668190001Medicare NSC
T28436Medicare UPIN
092119Medicare ID - Type Unspecified