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Organization
FOOT AND ANKLE MANAGEMENT OF VIRGINIA
Active
Organization
FOOT AND ANKLE MANAGEMENT OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA BOURAEE DPM (MANAGING MEMBER)
(757) 234-2905
Entity
Organization
Contact information
Practice address
1155 PROFESSIONAL DR, WILLIAMSBURG, VA 23185-3329
(757) 234-2905
Mailing address
1155 PROFESSIONAL DR, WILLIAMSBURG, VA 23185-3329
(757) 234-2905
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003926031
FOOT AND ANKLE SURGERY
VA
01
—
1285823401
FOOT AND ANKLE SURGERY
VA
01
—
1295193811
FOOT AND ANKLE SURGERY
VA
01
—
1326018615
FOOT AND ANKLE SURGERY
VA
Enumeration date
03/21/2022
Last updated
03/21/2022
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