Individual
PINK WIMBISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1934 BRAEBURN DR, SALEM, VA 24153-7302
(540) 982-0253
(540) 982-1996
Mailing address
1934 BRAEBURN DR, SALEM, VA 24153-7302
(540) 982-0253
(540) 982-1996
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000859
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010191980
—
VA
01
—
181786
ANTHEM BC BS
VA
01
—
480011609
RAILROAD MEDICARE
VA
01
—
P00276625
RAILROAD MEDICARE
VA
Enumeration date
05/17/2006
Last updated
11/23/2016
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