Provider Demographics
NPI:1598718116
Name:ADVANCED FOOT & ANKLE SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:ADVANCED FOOT & ANKLE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERCIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:919-554-0711
Mailing Address - Street 1:337 S WHITE ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2916
Mailing Address - Country:US
Mailing Address - Phone:919-554-0711
Mailing Address - Fax:919-554-1185
Practice Address - Street 1:337 S WHITE ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2916
Practice Address - Country:US
Practice Address - Phone:919-554-0711
Practice Address - Fax:919-554-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017HEOtherBCBS
NC5902530Medicaid
D355OtherPARTNERS
DE0017OtherRAILROAD MEDICARE
D355OtherPARTNERS