Organization
FOOT AND ANKLE CLINIC OF THE VIRGINIAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J DONATELLI DPM (OWNER)
(800) 292-3008
Entity
Organization
Contact information
Practice address
401 ROGERS ST, PRINCETON, WV 24740-3636
(800) 292-3008
(412) 291-1552
Mailing address
PO BOX 825159, PHILADELPHIA, PA 19182-5159
(800) 292-3008
(866) 420-4578
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706519
MOUNTAIN STATE BC BS
WV
05
—
010201641
—
VA
05
—
3810007768
—
WV
01
—
DD3197
RAILROAD MEDICARE
WV
Enumeration date
05/31/2006
Last updated
02/26/2025
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