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Organization
DOMINION FOOT AND ANKLE CENTER,LTD.
Active
Organization
DOMINION FOOT AND ANKLE CENTER,LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KENNETH MARINO DPM (PRESIDENT)
(804) 378-1818
Entity
Organization
Contact information
Practice address
13305A MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-4211
(804) 378-1818
(804) 378-1818
Mailing address
PO BOX 561, MIDLOTHIAN, VA 23113-0561
(804) 378-1818
(804) 794-3827
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000786
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480011660
RAILROAD MEDICARE PIN
VA
05
—
9332014
—
VA
Enumeration date
04/25/2008
Last updated
04/25/2008
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