Provider Demographics
NPI:1093981938
Name:ASSOCIATED FOOT AND ANKLE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ASSOCIATED FOOT AND ANKLE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:937-435-6585
Mailing Address - Street 1:2 PRESTIGE PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3770
Mailing Address - Country:US
Mailing Address - Phone:937-435-6585
Mailing Address - Fax:
Practice Address - Street 1:2 PRESTIGE PL
Practice Address - Street 2:SUITE 210
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3770
Practice Address - Country:US
Practice Address - Phone:937-435-6585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty