Organization
GREENVILLE FOOT & ANKLE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL J CIVATTE DPM (MEMBER/MANAGER)
(252) 321-0203
Entity
Organization
Contact information
Practice address
2409 S CHARLES BLVD, GREENVILLE, NC 27858-5925
(252) 321-0203
(252) 353-5669
Mailing address
2409 S CHARLES BLVD, GREENVILLE, NC 27858-5925
(252) 321-0203
(252) 353-5669
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
239
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08015
BCBS/STATE
NC
05
—
7908015
—
NC
Enumeration date
09/13/2005
Last updated
02/08/2008
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