Provider Demographics
NPI:1063757235
Name:WEST END FOOT AND ANKLE
Entity type:Organization
Organization Name:WEST END FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-346-1779
Mailing Address - Street 1:7650 E PARHAM RD STE 215
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4383
Mailing Address - Country:US
Mailing Address - Phone:804-346-1779
Mailing Address - Fax:804-545-9040
Practice Address - Street 1:7650 E PARHAM RD STE 215
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4383
Practice Address - Country:US
Practice Address - Phone:804-346-1779
Practice Address - Fax:804-545-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001050213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1251610001Medicare NSC