Provider Demographics
NPI:1699119214
Name:INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Entity type:Organization
Organization Name:INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:704-542-8253
Mailing Address - Street 1:10370 PARK RD
Mailing Address - Street 2:100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8508
Mailing Address - Country:US
Mailing Address - Phone:704-542-8253
Mailing Address - Fax:
Practice Address - Street 1:10370 PARK RD
Practice Address - Street 2:100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8508
Practice Address - Country:US
Practice Address - Phone:704-542-8253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty