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General NPI Number Information
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NPI Number | 1487735494
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Entity Type | Organization
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Legal Business Name | CABARRUS PODIATRY ASSOCIATES PC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 851 BRADLEY ST
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City | CONCORD
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State | NC
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Zip | 28025-2979
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Country | US
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Telephone | 704-788-1142
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Fax | 704-782-7912
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Provider Business Mailing Address
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Address Line | 851 BRADLEY STREET
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City | CONCORD
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State | NC
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Zip | 28025
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Country | US
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Telephone | 704-788-1142
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Fax | 704-782-7912
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN MICHAEL DIEHL SR.
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Credential | DPM
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Telephone | 704-788-1142
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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 | 150
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License Number State | NC
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