# EASTOVER FOOT & ANKLE PA

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

## Provider details

- **NPI number:** 1932297264
- **Authorized official:** RONALD VICTOR FUTERMAN DPM (PRESIDENT)
- **Authorized official phone:** (704) 841-4000

## Contact information

- **Practice address:** 428 N. TRADE STREET, SUITE 100, MATTHEWS, NC 28105-5017
- **Practice address phone:** (704) 841-4000
- **Practice address fax:** (704) 841-4338
- **Mailing address:** PO BOX 1539, MATTHEWS, NC 28106-1539
- **Mailing address phone:** (704) 841-4000
- **Mailing address fax:** (704) 841-4338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 200001392347 | NC | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 10/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0172M | BLUE CROSS BLUE SHIELD NC | NC |
| 05 | — | 890172M | — | NC |