Provider Demographics
NPI:1770542599
Name:FOOT AND ANKLE SPECIALISTS OF VIRGINIA PC
Entity type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF VIRGINIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIMOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-359-7412
Mailing Address - Street 1:3805 CUTSHAW AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3943
Mailing Address - Country:US
Mailing Address - Phone:804-359-7412
Mailing Address - Fax:804-359-7418
Practice Address - Street 1:241 CHARLES DIMMOCK PKWY
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834
Practice Address - Country:US
Practice Address - Phone:804-520-5057
Practice Address - Fax:804-520-8791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACL2381OtherRR MEDICARE GROUP #
VAC01647Medicare PIN
VACL2381OtherRR MEDICARE GROUP #