Crispell, Brian Dale
Crispell, Brian Dale is an sole proprietor health care provider with primary practice located at 1078 W Baltimore Pike Riddle Health Center 1, Suite 209, Media PA 19063-5105. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Crispell, Brian Dale can be contacted via phone (610) 334-7657.Contact Information
Primary practice address
1078 W Baltimore Pike Riddle Health Center 1, Suite 209
Media PA 19063-5105
Phone: (610) 334-7657
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | SC005698 | Pennsylvania |
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | SC005698 | Pennsylvania |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | SC005698 | Pennsylvania |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | SC005698 | Pennsylvania |
Profile Details
| NPI number | 1306806765 |
|---|---|
| LBN Legal business name | Crispell, Brian Dale |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2006 |
| Last updated | Jun 13th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306806765 | NPPES |
| Pennsylvania | MEDICAID | 1015531700005 | |
| Pennsylvania | Other | 329832 |
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