Provider Demographics
NPI:1932184546
Name:CAROLINA FOOT SPECIALISTS PLLC
Entity type:Organization
Organization Name:CAROLINA FOOT SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CORY
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:919-846-1111
Mailing Address - Street 1:1505 SW CARY PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6219
Mailing Address - Country:US
Mailing Address - Phone:919-460-7744
Mailing Address - Fax:919-460-0226
Practice Address - Street 1:1505 SW CARY PARKWAY
Practice Address - Street 2:STE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-460-7744
Practice Address - Fax:919-460-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01556OtherBCBS
230456Medicare ID - Type Unspecified