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General NPI Number Information
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NPI Number | 1497868889
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Entity Type | Organization
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Legal Business Name | AMBULATORY FOOT & ANKLE CENTER, P.C.
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 1618 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2400
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Country | US
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Telephone | 757-825-5783
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Fax | 757-825-9658
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Provider Business Mailing Address
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Address Line | 1618 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2400
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Country | US
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Telephone | 757-825-5783
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Fax | 757-825-9658
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. EARNEST P.S. MAWUSI
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Credential | DPM
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Telephone | 757-825-5783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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