| NPI | 1770156911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN C MCDONALD Board President 704-786-4482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 213ES0131X Podiatrist, Foot Surgery | |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2021-07-23 |