Organization
COMPREHENSIVE FOOT AND ANKLE CENTER,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY J NELLAS DPM (OWNER)
(704) 562-6384
Entity
Organization
Contact information
Practice address
1928 RANDOLPH RD, SUITE 214, CHARLOTTE, NC 28207-1105
(704) 562-6384
Mailing address
1928 RANDOLPH ROAD, SUITE 214, CHARLOTTE, NC 28207-1105
(704) 332-5115
(704) 332-5116
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
413
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
790801Y
—
NC
01
—
D02704
MEDICARE RAILROAD
NC
05
—
NPD413
—
SC
Enumeration date
12/17/2007
Last updated
01/26/2010
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