Organization · Type 2 NPI
Tidewater Foot Center LLC
Foot Surgery Podiatrist · Newport News, VA
NPI number
1891137048
Active
Practice location
126 Monarch Dr
Newport News, VA 23602-6884
Fax (757) 597-7099
Mailing address
11747 Jefferson Ave Ste 2A
Newport News, VA 23606-4402
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot Surgery Podiatrist Primary | 213ES0131X | 0103301081 (VA) |
Foot Surgery Podiatrist: Definition to come...
About NPI 1891137048
Tidewater Foot Center LLC's National Provider Identifier is 1891137048, issued on Jul 29, 2013. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in Newport News, VA. The record was last updated on Dec 9, 2013.