OrganizationActive
Foot and Ankle Specialists of the Mid Atlantic LLC
NPI 1063306132 · Non-Pharmacy Dispensing Site · Lake Ridge, VA
Provider details
- NPI number
- 1063306132
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Rosalie Kreighbaum, Regional Credentialing Specialist(314) 909-1920
Specialties & taxonomies
Suppliers
Practice location
1721 Financial Loop
Lake Ridge, VA 22192-2460
Phone: (703) 491-9500
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 825159
Philadelphia, PA 19182-5159
Registry dates
- Enumerated
- 2025-06-04
- Last updated
- 2025-06-04
- Certified
- 2025-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.