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Organization
INDIANA FOOT AND ANKLE SPECIALIST LLC
Active
Organization
INDIANA FOOT AND ANKLE SPECIALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW T DEWITT DPM (OWNER)
(765) 729-1083
Entity
Organization
Contact information
Practice address
2106 W MCGALLIARD RD, MUNCIE, IN 47304-2150
(765) 284-3879
Mailing address
2106 W MCGALLIARD RD, MUNCIE, IN 47304-2150
(765) 284-3879
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
NULL
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Enumeration date
10/21/2020
Last updated
02/04/2021
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