Provider Demographics
NPI:1871847582
Name:INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:919-570-9061
Mailing Address - Street 1:PO BOX 1060
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-1060
Mailing Address - Country:US
Mailing Address - Phone:919-570-9061
Mailing Address - Fax:919-570-9064
Practice Address - Street 1:833 WAKE FOREST BUSINESS PARK STE C
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6521
Practice Address - Country:US
Practice Address - Phone:919-570-9061
Practice Address - Fax:919-570-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6712460020Medicare NSC
NCB699Medicare PIN