Healthcare Provider Details

I. General information

NPI: 1619915501
Provider Name (Legal Business Name): RALEIGH FOOT CENTER,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 E MILLBROOK RD
RALEIGH NC
27609-4812
US

IV. Provider business mailing address

PO BOX 98209
RALEIGH NC
27624-8209
US

V. Phone/Fax

Practice location:
  • Phone: 919-850-9111
  • Fax: 919-850-2499
Mailing address:
  • Phone: 919-850-9111
  • Fax: 919-850-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M HATCHER
Title or Position: PRESIDENT
Credential: DPM
Phone: 919-850-9111