Organization
FOOT AND ANKLE MANAGEMENT OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA BOURAEE DPM (MANAGING MEMBER)
(757) 234-2905
Entity
Organization
Contact information
Practice address
1155 PROFESSIONAL DR, WILLIAMSBURG, VA 23185-3329
(757) 234-2905
Mailing address
1155 PROFESSIONAL DR, WILLIAMSBURG, VA 23185-3329
(757) 234-2905
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003926031
FOOT AND ANKLE SURGERY
VA
01
—
1285823401
FOOT AND ANKLE SURGERY
VA
01
—
1295193811
FOOT AND ANKLE SURGERY
VA
01
—
1326018615
FOOT AND ANKLE SURGERY
VA
Enumeration date
03/21/2022
Last updated
03/21/2022
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