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General NPI Number Information
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NPI Number | 1356462303
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE FOOT AND ANKLE CENTER PC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 300 MEDICAL PKWY SUITE 303
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4985
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Country | US
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Telephone | 757-436-5824
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Fax | 757-548-4048
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Provider Business Mailing Address
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Address Line | 300 MEDICAL PKWY SUITE 303
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4985
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Country | US
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Telephone | 757-436-5824
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Fax | 757-548-4048
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DONNA L COLLINS
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Credential |
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Telephone | 757-436-5824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103000785
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License Number State | VA
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