MEDICARE: INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1053665729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	1036 BRANCHVIEW DR STE 216
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-0113
Country	:	US
Telephone Number	:	704-886-1918
Fax Number	:	704-257-2049

Provider Business Practice Location Address
First Line	:	530 N ELAM AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-1153
Country	:	US
Telephone Number	:	336-299-0817
Fax Number	:	336-299-8117

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ELDON PETERS
Credential	:
Telephone Number	:	919-829-0076

Provider Enumeration Date	:	11/02/2012
Last Update Date	:	08/20/2025

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