Healthcare Provider Details
I. General information
NPI: 1316079569
Provider Name (Legal Business Name): WILMINGTON FOOT AND ANKLE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2007
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
702 E BASIN RD SUITE 3
NEW CASTLE DE
19720-4263
US
IV. Provider business mailing address
702 E BASIN RD SUITE 3
NEW CASTLE DE
19720-4263
US
V. Phone/Fax
- Phone: 302-221-6880
- Fax: 302-221-6883
- Phone: 302-221-6880
- Fax: 302-221-6883
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 2001106842 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RODNEY
TODD
GROBES
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 302-221-6880