institution
Coastal Carolina Foot & Ankle Association Pa
Foot Surgery Podiatrist in Wallace, North Carolina
NPI 1639336027

Coastal Carolina Foot & Ankle Association Pa is a Foot Surgery Podiatrist based in Wallace, NC and is specialized in Foot Surgery. Coastal Carolina Foot & Ankle Association Pa practices in Wallace, NC. The NPI Number for Coastal Carolina Foot & Ankle Association Pa is 1639336027 and holds a License No. 230 (North Carolina).

The current practice location address for Coastal Carolina Foot & Ankle Association Pa is 114 N Norwood St, Wallace, NC and can be reached out via phone at 910-285-3362 and via fax at 910-285-6683.

Location: 114 N Norwood St, Wallace, NC, 28466-2730
institution
Provider Profile Details
NPI Number
1639336027
Provider Name
Coastal Carolina Foot & Ankle Association Pa
Credential
Provider Entity Type
Organization
Address
114 N Norwood St, Wallace, NC, 28466-2730
Phone Number
910-285-3362
Fax Number
910-285-6683
Provider Enumeration Date
05/22/2008
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
890152P 05 NC
DR7169 01 NC RAILROAD MEDICARE PTAN
B1114 01 NC MEDCOST
2347992 01 NC MEDICARE PTAN
0152P 01 NC BCBS NC
institution
Provider Business Practice Location Address Details
Address
114 N Norwood St
City
State
Zip
28466-2730
Phone Number
910-285-3362
Fax Number
910-285-6683
person
Provider Business Mailing Address Details
Address
114 N Norwood St
City
State
Zip
28466-2730
Phone Number
910-285-3362
Fax Number
910-285-6683
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
449 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
230 (North Carolina)
Definition
Definition to come...
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