Provider Demographics
NPI:1316079569
Name:WILMINGTON FOOT AND ANKLE CENTER INC.
Entity type:Organization
Organization Name:WILMINGTON FOOT AND ANKLE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:GROBES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:302-221-6880
Mailing Address - Street 1:702 E BASIN RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-4263
Mailing Address - Country:US
Mailing Address - Phone:302-221-6880
Mailing Address - Fax:302-221-6883
Practice Address - Street 1:702 E BASIN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4263
Practice Address - Country:US
Practice Address - Phone:302-221-6880
Practice Address - Fax:302-221-6883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
DE2001106842213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000898750Medicaid
DEG01643Medicare PIN
DE4732070001Medicare NSC