Richard    Egerman    DPM
Contract Details
Ancillary Care Services
Facility name
Provider ID
P000005595
NPI
1912004052
Tax ID
133403690
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
13489 South Military Trail
Delray Beach, FL 33484
United States
County
Palm Beach
Phone
5614959700 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address