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Organization
AMBULATORY FOOT CARE CENTER P C
Active
Organization
AMBULATORY FOOT CARE CENTER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T CANAVAN DPM (PHYSICIAN OWNER)
(434) 799-9430
Entity
Organization
Contact information
Practice address
789 PINEY FOREST RD, SUITE B, DANVILLE, VA 24540-2877
(434) 799-9430
(434) 792-8438
Mailing address
789 PINEY FOREST RD, SUITE B, DANVILLE, VA 24540-2877
(434) 799-9430
(434) 792-8438
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103 000583
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009301631
—
VA
01
—
066476
ANTHEM
VA
01
—
1891739991
DR MICHAEL CANAVAN NPI #
VA
01
—
46126
OPTIMA
VA
05
—
890803N
—
NC
01
—
C02497
MEDICARE PTAN
—
01
—
CF9579
RET RAILROAD MCRE
VA
Enumeration date
04/19/2007
Last updated
03/29/2013
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