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General NPI Number Information
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NPI Number | 1174212229
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Entity Type | Organization
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Legal Business Name | DOCTOR FOOT CARE, PLLC
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1325 BRAEBURN RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-4770
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Country | US
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Telephone | 646-427-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 10020 MONROE RD SUITE 170 - 127
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City | MATTHEWS
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State | NC
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Zip | 28105
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Country | US
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Telephone | 980-737-3957
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Fax |
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Authorized Official
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Title or Position | OWNER, PODIATRIST
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Name | DR. IDA M LIM
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Credential | DPM
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Telephone | 646-427-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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