Healthcare Provider Details

I. General information

NPI: 1316999527
Provider Name (Legal Business Name): CAPE FEAR PODIATRY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 METROMEDICAL DR
FAYETTEVILLE NC
28304-3861
US

IV. Provider business mailing address

1738 METROMEDICAL DR
FAYETTEVILLE NC
28304-3861
US

V. Phone/Fax

Practice location:
  • Phone: 910-484-4191
  • Fax: 910-484-5546
Mailing address:
  • Phone: 910-484-4191
  • Fax: 910-484-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: SANDRA SHEEHAN
Title or Position: DPM
Credential: DPM
Phone: 910-484-4191