Organization · NPI-2

Diabetic Foot Center Of Tidewater

Podiatrist, Foot & Ankle Surgery · Norfolk, VA

NPI number1306904800
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1306904800
Entity type
Organization (NPI-2)
Legal business name
Diabetic Foot Center Of Tidewater
Organization subpart
No
Enumeration date
Dec 5, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0103X Podiatrist, Foot & Ankle Surgery––Yes

Other names

  • Janaf Foot And Ankle Center (Doing Business As)

Practice location

5900 E. Virginia Beach Blvd
Suite 101
Norfolk, VA 23502

Phone 757-461-4500 · Fax 757-466-0928

Mailing address

5900 E. Virginia Beach Blvd
Suite 101
Norfolk, VA 23502

Phone 757-461-4500 · Fax 757-466-0928

Authorized official

William P. Grant
Owner
7574614500

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