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Organization

NOVA FOOT & ANKLE CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KOSTADINKA HADZIJSKA SKANDEVA DPM (OWNER)
(571) 480-8480
Entity
Organization

Contact information

Practice address
6151 FULLER CT, ALEXANDRIA, VA 22310-2541
(571) 480-8480
(703) 888-3909
Mailing address
6151 FULLER CT, ALEXANDRIA, VA 22310-2541
(571) 480-8480
(703) 888-3909

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
0103301045
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326279084
VA
01
6683570001
MEDICARE DME PTAN
VA
Enumeration date
02/27/2012
Last updated
02/20/2013
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