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Individual

DR. JOHN P MIKETA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
122 NORTH MAIN ST, FUQUAY VARINA, NC 27526-1933
(919) 557-5148
(919) 557-5645
Mailing address
122 NORTH MAIN ST, FUQUAY VARINA, NC 27526-1933
(919) 557-5148
(919) 557-5645

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
337
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
337
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7908110
NC
Enumeration date
05/01/2007
Last updated
08/04/2008
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