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General NPI Number Information
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NPI Number | 1528497047
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Entity Type | Organization
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Legal Business Name | GEORGE VITO DPM & ASSOCIATES
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 2185 BURKE MEADOWS RD APT 107
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6866
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Country | US
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Telephone | 336-618-6961
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24561
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City | WINSTON SALEM
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State | NC
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Zip | 27114-4561
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Country | US
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Telephone | 336-618-6961
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. GEORGE VITO
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Credential | DPM
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Telephone | 336-618-6961
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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 | 330
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License Number State | NC
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