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General NPI Number Information
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NPI Number | 1174695357
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Entity Type | Organization
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Legal Business Name | CENTER FOR PODIATRY CARE
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/28/2018
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Provider Practice Location Address
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Address Line | 462 FURYS FERRY RD
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City | MARTINEZ
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State | GA
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Zip | 30907
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Country | US
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Telephone | 706-868-0319
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Fax | 706-868-3719
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Provider Business Mailing Address
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Address Line | 462 FURYS FERRY RD
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City | MARTINEZ
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State | GA
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Zip | 30907-9506
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Country | US
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Telephone | 706-868-0319
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Fax | 706-868-3719
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. JANAKI NADARAJAH
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Credential | DPM
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Telephone | 706-868-0319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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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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