Provider Demographics
NPI:1851923023
Name:CENTER FOR ADVANCED FOOT & ANKLE SURGERY, INC.
Entity Type:Organization
Organization Name:CENTER FOR ADVANCED FOOT & ANKLE SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-991-3668
Mailing Address - Street 1:621 S NEW BALLAS RD STE 7005B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8275
Mailing Address - Country:US
Mailing Address - Phone:314-991-3668
Mailing Address - Fax:314-991-3665
Practice Address - Street 1:3915 WATSON RD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1251
Practice Address - Country:US
Practice Address - Phone:314-352-2711
Practice Address - Fax:314-644-5081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR ADVANCED FOOT & ANKLE SURGERY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty