Healthcare Provider Details

I. General information

NPI: 1508238015
Provider Name (Legal Business Name): INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2015
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 PROFESSIONAL PARK DR
CONWAY SC
29526-9260
US

IV. Provider business mailing address

1036 BRANCHVIEW DR STE 216
CONCORD NC
28025-0113
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-3334
  • Fax:
Mailing address:
  • Phone: 704-886-1918
  • Fax: 704-257-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM CHARLES MYERS
Title or Position: ADMIN
Credential:
Phone: 843-347-3334