Organization
NORTH ATLANTIC PODIATRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE MCCULLOUGH (DPM)
(978) 458-4011
Entity
Organization
Contact information
Practice address
83 SHERIDAN AVE, MEDFORD, MA 02155-4042
(978) 458-4011
(978) 458-4020
Mailing address
83 SHERIDAN AVE, MEDFORD, MA 02155-4042
(978) 458-4011
(978) 458-4020
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
11/14/2007
Last updated
07/03/2008
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