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NPI Code Detail

MEDICARE: PIEDMONT FOOT AND ANKLE ASSOCIATES PC

MEDICARE: PIEDMONT FOOT AND ANKLE ASSOCIATES 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
1213ES0103XFoot & Ankle Surgery Podiatrist

General Provider Information

NPI Number : 1942314802
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIEDMONT FOOT AND ANKLE ASSOCIATES PC
Provider Business Mailing Address
First Line : 3641 WESTGATE CENTER CIR
Second Line : SUITE A
City : WINSTON SALEM
State : NC
Zip : 27103-2936
Country : US
Telephone Number : 919-751-9120
Fax Number : 919-751-9170
Provider Business Practice Location Address
First Line : 3641 WESTGATE CENTER CIR
Second Line : SUITE A
City : WINSTON SALEM
State : NC
Zip : 27103-2936
Country : US
Telephone Number : 919-751-9120
Fax Number : 919-751-9170
Authorized Official
Title or Position : VICE PRESIDENT
Name : DR. THURMOND E SICELOFF
Credential : DPM
Telephone Number : 919-751-9120
Provider Enumeration Date : 08/18/2006
Last Update Date : 04/20/2008

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