Provider Demographics
NPI:1497935506
Name:VIRGINIA FOOT & ANKLE CENTER, P.C.
Entity Type:Organization
Organization Name:VIRGINIA FOOT & ANKLE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:VANTRE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-285-3933
Mailing Address - Street 1:2004 BREMO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2442
Mailing Address - Country:US
Mailing Address - Phone:804-285-3933
Mailing Address - Fax:804-288-1384
Practice Address - Street 1:2004 BREMO RD STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2442
Practice Address - Country:US
Practice Address - Phone:804-285-3933
Practice Address - Fax:804-288-1384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300918213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5367930001Medicare NSC