Provider Demographics
NPI:1528257243
Name:COMMUNITY FOOT CARE CENTER
Entity type:Organization
Organization Name:COMMUNITY FOOT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEFFAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-985-0597
Mailing Address - Street 1:116 S POPLAR ST STE 5
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-4500
Mailing Address - Country:US
Mailing Address - Phone:540-985-0597
Mailing Address - Fax:540-985-0598
Practice Address - Street 1:116 S POPLAR ST STE 5
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:VA
Practice Address - Zip Code:24179-4500
Practice Address - Country:US
Practice Address - Phone:540-985-0597
Practice Address - Fax:540-985-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000734213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009330771Medicaid
VA5362870001Medicare NSC
VAC09375Medicare PIN
VA009330771Medicaid