Provider Demographics
NPI:1164542023
Name:ADVANCED FOOT AND ANKLE CARE P.C.
Entity Type:Organization
Organization Name:ADVANCED FOOT AND ANKLE CARE P.C.
Other - Org Name:ADVANCED CHIROPRACTIC CARE, P.C,
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-749-7826
Mailing Address - Street 1:23 STRICKLER AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1858
Mailing Address - Country:US
Mailing Address - Phone:717-749-7826
Mailing Address - Fax:717-387-5026
Practice Address - Street 1:23 STRICKLER AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-1858
Practice Address - Country:US
Practice Address - Phone:717-749-7826
Practice Address - Fax:717-387-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-01
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007570L111N00000X
PASC005954213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101759765 0001Medicaid
PA101759765 0001Medicaid
U98848Medicare UPIN
PA120318Medicare PIN
PA5938050001Medicare NSC