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Organization
CLIFTON FOOT AND ANKLE CENTER P.C.
Active
Organization
CLIFTON FOOT AND ANKLE CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH REED WILHELM DPM (PRESIDENT)
(703) 996-3000
Entity
Organization
Contact information
Practice address
6101 REDWOOD SQUARE CENTER, SUITE 303, CENTREVILLE, VA 20121-4269
(703) 996-3000
(703) 229-1152
Mailing address
6101 REDWOOD SQUARE CTR, SUITE 303, CENTREVILLE, VA 20121-4265
(703) 996-3000
(703) 229-1152
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000986
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009302531
—
VA
01
—
6614380001
DME PTAN
VA
Enumeration date
10/26/2011
Last updated
05/13/2013
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