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NPI Code Detail

MEDICARE: CEDAR VALLEY PODIATRY, PC

MEDICARE: CEDAR VALLEY PODIATRY, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0131XFoot Surgery Podiatrist
2213ES0103XFoot & Ankle Surgery Podiatrist
3213E00000XPodiatrist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1I7692OTHERIAMEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932139243
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEDAR VALLEY PODIATRY, PC
Provider Business Mailing Address
First Line : 4508 CHADWICK RD
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-7958
Country : US
Telephone Number : 319-277-4508
Fax Number : 319-277-8908
Provider Business Practice Location Address
First Line : 4508 CHADWICK RD
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-7958
Country : US
Telephone Number : 319-277-4508
Fax Number : 319-277-8908
Authorized Official
Title or Position : OFFICE MANAGER
Name : ROXANNE MASTELLER
Credential :
Telephone Number : 319-277-4508
Provider Enumeration Date : 07/03/2006
Last Update Date : 02/11/2020

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Directions to “CEDAR VALLEY PODIATRY, PC ” Practice Location

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