TIDEWATER FOOT & ANKLE CENTER PC NPI 1497813158

NPI Information

TIDEWATER FOOT & ANKLE CENTER, PC is a foot and ankle surgery podiatrist in Virginia Beach, VA. TIDEWATER FOOT & ANKLE CENTER, PC NPI is 1497813158. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

760 INDEPENDENCE BLVD
VIRGINIA BEACH, VA
ZIP 23455-206
Phone: (757) 497-7575

The provider's authorized official is William P. Grant .
The authorized official title is Owner and has the following contact phone number (757) 497-7575.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 5/13/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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