Provider Demographics
NPI:1497376370
Name:CAROLINA FOOT & ANKLE OF HUNTERSVILLE, PC
Entity Type:Organization
Organization Name:CAROLINA FOOT & ANKLE OF HUNTERSVILLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:QUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-987-9585
Mailing Address - Street 1:16419 NORTHCROSS DR STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5009
Mailing Address - Country:US
Mailing Address - Phone:704-987-9585
Mailing Address - Fax:704-987-9589
Practice Address - Street 1:10310 COULOAK DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-7673
Practice Address - Country:US
Practice Address - Phone:704-971-4000
Practice Address - Fax:704-971-2379
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA FOOT AND ANKLE OF HUNTERSVILLE,PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty