Provider Demographics
NPI:1285767624
Name:BEDFORD PODIATRY & FOOT SURGERY, P.C.
Entity type:Organization
Organization Name:BEDFORD PODIATRY & FOOT SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-587-6963
Mailing Address - Street 1:876 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-2904
Mailing Address - Country:US
Mailing Address - Phone:540-587-6963
Mailing Address - Fax:540-587-6962
Practice Address - Street 1:876 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-2904
Practice Address - Country:US
Practice Address - Phone:540-587-6963
Practice Address - Fax:540-587-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000619213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF9416OtherRR MCR
VA296673OtherANTHEM
5932170001Medicare NSC
VA296673OtherANTHEM
DF9416OtherRR MCR
VAU13948Medicare UPIN