Provider Demographics
NPI:1477894954
Name:ADVANCED PODIATRIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ADVANCED PODIATRIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-857-7170
Mailing Address - Street 1:31 MEETING HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02659-1400
Mailing Address - Country:US
Mailing Address - Phone:508-857-7170
Mailing Address - Fax:508-772-4363
Practice Address - Street 1:31 MEETING HOUSE RD
Practice Address - Street 2:
Practice Address - City:SOUTH CHATHAM
Practice Address - State:MA
Practice Address - Zip Code:02659-1400
Practice Address - Country:US
Practice Address - Phone:508-857-7170
Practice Address - Fax:508-772-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2142213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty