NPI 1376795765 · live from the CMS NPI Registry
Associated Foot & Ankle Centers Of Northern Virginia PC
Podiatrist, Foot & Ankle Surgery in Fairfax, VA. National Provider Identifier 1376795765, active.
NPI record
| NPI | 1376795765 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 10730 Main St, Fairfax, VA 22030 |
| Practice phone | 703-691-0670 |
| Mailing address | 1721 Financial Loop, Lake Ridge, VA 22192 |
| Enumerated | October 16, 2008 |
| Last updated | December 30, 2013 |
| Authorized official | Douglas Stabile, President |
| Other names | Lakeridge Foot & Ankle Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 0103000774 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.