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Organization
FAYETTEVILLE FOOT AND ANKLE CENTER
Active
Organization
FAYETTEVILLE FOOT AND ANKLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE JOHN DEMETRI JR. D.P.M. (DOCTOR)
(910) 483-3338
Entity
Organization
Contact information
Practice address
503 OWEN DR, FAYETTEVILLE, NC 28304-3433
(910) 483-3338
(910) 483-3386
Mailing address
503 OWEN DR, FAYETTEVILLE, NC 28304-3433
(910) 483-3338
(910) 483-3386
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
240
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153T
BLUE CROSS BLUE SHIELD
NC
05
—
890805F
—
NC
Enumeration date
02/16/2007
Last updated
03/22/2011
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