# MECKLENBURG FOOT & ANKLE ASSOCIATES AND DIABETIC FOOT CLINIC PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881724227
- **Authorized official:** DR. ROBERT MITCHELL LIESMAN DPM (PRESIDENT, OWNER)
- **Authorized official phone:** (704) 442-8433

## Contact information

- **Practice address:** 2115 E 7TH ST STE 102, CHARLOTTE, NC 28204-3300
- **Practice address phone:** (704) 442-8433
- **Practice address fax:** (704) 817-9957
- **Mailing address:** 2115 E 7TH ST STE 102, CHARLOTTE, NC 28204-3300
- **Mailing address phone:** (704) 442-8433
- **Mailing address fax:** (704) 817-9957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 356 | NC | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 11/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0268L | GROUP NUMBER | NC |
| 05 | — | 890268L | — | NC |