| NPI | 1982210613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN C MCDONALD 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 | 2020-09-18 |
| Last Update Date | 2020-09-21 |