Basic Information
Provider Information
NPI: 1740456318
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINTERS
FirstName: BRIAN
MiddleName: SETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 833 CHESTNUT ST STE 520
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191074430
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber: 6724791321
Practice Location
Address1: 2500 ENGLISH CREEK AVE
Address2: BUILDING 1300
City: EGG HARBOR TOWNSHIP
State: NJ
PostalCode: 082345549
CountryCode: US
TelephoneNumber: 6096776060
FaxNumber: 6096776061
Other Information
ProviderEnumerationDate: 05/05/2008
LastUpdateDate: 03/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XX0004X303456NYN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
207XX0004XMD442024PAN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
207XX0004X25MA09269800NJY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery

No ID Information.


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