Healthcare Provider Details
I. General information
NPI: 1104097567
Provider Name (Legal Business Name): FAMILY FOOT CARE CENTERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2008
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 VOLVO PKWY SUITE 130
CHESAPEAKE VA
23320-2811
US
IV. Provider business mailing address
801 VOLVO PKWY SUITE 130
CHESAPEAKE VA
23320-2811
US
V. Phone/Fax
- Phone: 757-547-3668
- Fax: 757-547-4335
- Phone: 757-547-3668
- Fax: 757-547-4335
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARC
J
FINK
Title or Position: PHYSICIAN
Credential: DPM
Phone: 757-547-3668