is a Podiatrist in , . practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for is 1376595801. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1376595801 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
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| Taxonomy | 213E00000X |
| Licence No | 116 |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 890802R | NC | -- | |
| 0802R | NC | BLUECROSS/BLUESHIELD | |
| 23656 | NC | MEDCOST | |
| 1659398 | NC | OXFORD HEALTH UHC | |
| 2728879 | NC | UNITED HEALTHCARE | |
| P02480-31 | NY | NY WORKERS COMP | |
| 1079890001 | NC | PALMETTO DURABLE GOODS |
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