Healthcare Provider Details

I. General information

NPI: 1831369578
Provider Name (Legal Business Name): CAPITAL FOOT CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PUMP RD STE 227
HENRICO VA
23233
US

IV. Provider business mailing address

2200 PUMP RD STE 227
HENRICO VA
23233-3539
US

V. Phone/Fax

Practice location:
  • Phone: 804-754-7400
  • Fax: 804-754-7402
Mailing address:
  • Phone: 804-754-7400
  • Fax: 804-754-7402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES E SHADBOLT
Title or Position: PRESIDENT
Credential: DPM
Phone: 804-754-7400