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Organization
FOOT & ANKLE MEDICAL CENTER, LLC
Active
Organization
FOOT & ANKLE MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER ROSS GRINKEWITZ DPM (PRESIDENT/PHYSICIAN)
(757) 393-1074
Entity
Organization
Contact information
Practice address
3640 HIGH ST, SUITE D1, PORTSMOUTH, VA 23707-3213
(757) 393-1074
(757) 318-7003
Mailing address
PO BOX 55350, VIRGINIA BEACH, VA 23471-9350
(757) 393-1074
(757) 318-7003
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000751
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009303405
—
VA
01
—
057781
BLUE CROSS BLUE SHIELD
VA
01
—
232438625
TRICARE
VA
Enumeration date
03/04/2011
Last updated
03/04/2011
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