NPI 1811079965 · live from the CMS NPI Registry
Chantilly Foot & Ankle Center, LLC
Podiatrist, Foot & Ankle Surgery in Chantilly, VA. National Provider Identifier 1811079965, active.
NPI record
| NPI | 1811079965 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 4080 Lafayette Center Dr, Suite 170, Chantilly, VA 20151 |
| Practice phone | 703-490-5599 |
| Mailing address | Po Box 220734, Chantilly, VA 20153 |
| Enumerated | October 19, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Farshad Bathaee, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 0103300742 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.