Organization
FIRST STATE FOOT & ANKLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HOLVECK (OFFICE MANAGER)
(302) 984-0257
Entity
Organization
Contact information
Practice address
4512 KIRKWOOD HIGHWAY SUITE 203, WILMINGTON, DE 19808
(302) 984-0257
(302) 984-0258
Mailing address
4512 KIRKWOOD HIGHWAY SUITE 203, WILMINGTON, DE 19808
(302) 984-0257
(302) 984-0258
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1-0000143
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001047917
DELAWARE PHYSICIANS INC.
DE
05
—
1000027213
—
DE
01
—
2245524000
AMERIHEALTH/ KEYSTONE #
DE
01
—
7752539
AETNA GROUP #
DE
Enumeration date
07/26/2006
Last updated
07/07/2022
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