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NPI Code Detail

MEDICARE: DR. JAMES L CANTERBURY D.P.M.

MEDICARE: DR. JAMES L CANTERBURY D.P.M.
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
1213ES0103XFoot & Ankle Surgery Podiatrist36-00-2825-COH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P01458521OTHERWIRAILROAD MEDICARE
5P01555868OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881709905
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES L CANTERBURY D.P.M.
Provider Business Mailing Address
First Line : 1395 NW 167TH ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-5710
Country : US
Telephone Number : 614-702-7655
Fax Number :
Provider Business Practice Location Address
First Line : 5156 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-2424
Country : US
Telephone Number : 614-702-7655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 08/16/2021

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