Organization
NEXT STEP MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES STANLEY DAVIS III (ORTHOTIST)
(757) 802-3210
Entity
Organization
Contact information
Practice address
4501 N WITCHDUCK RD STE H, VIRGINIA BEACH, VA 23455
(757) 802-3210
(866) 421-0397
Mailing address
4501 N WITCHDUCK RD STE H, VIRGINIA BEACH, VA 23455-6217
(757) 802-3210
(866) 421-0397
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
246821-R
VA
335E00000X
Prosthetic/Orthotic Supplier
Primary
2018-2468-21-R
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740597202
TRICARE PRIME
VA
05
—
1740597202
—
VA
01
—
423608
ANTHEM
VA
01
—
P35205
HOMELINK
VA
Enumeration date
09/06/2010
Last updated
08/28/2018
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