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General NPI Number Information
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NPI Number | 1720353444
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Entity Type | Organization
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Legal Business Name | BROADWAY FOOT & ANKLE CENTER
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 1807 S BROADWAY
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City | CAMDEN
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State | NJ
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Zip | 08104-1333
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Country | US
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Telephone | 609-332-6187
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Fax | 856-854-7969
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Provider Business Mailing Address
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Address Line | PO BOX 116
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City | HADDONFIELD
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State | NJ
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Zip | 08033-0102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAVID C KRAATZ
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Credential | DPM
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Telephone | 856-854-3093
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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 |
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License Number State |
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