Provider Demographics
NPI:1306056825
Name:NEW RIVER VALLEY PODIATRY & FOOT SURGERY PC
Entity type:Organization
Organization Name:NEW RIVER VALLEY PODIATRY & FOOT SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEREDITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:340-951-3338
Mailing Address - Street 1:210 PROFESSIONAL PARK DR SE
Mailing Address - Street 2:STE 13
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6680
Mailing Address - Country:US
Mailing Address - Phone:340-951-3338
Mailing Address - Fax:340-951-1738
Practice Address - Street 1:210 PROFESSIONAL PARK DR SE
Practice Address - Street 2:SUITE 13
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6680
Practice Address - Country:US
Practice Address - Phone:340-951-3338
Practice Address - Fax:340-951-1738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACI1132OtherRAILROAD MEDICARE
VACI1132OtherRAILROAD MEDICARE