Organization
THE ORTHOPAEDIC CENTER FOR FOOT & ANKLE RECONSTRUCTION
Active
Other names
THE ORTHOPAEDIC CENTER FOR FOOT AND ANKLE RECONSTRUCTION
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MICHAEL GRAHAM M.D. (PRESIDENT/DIRECTOR)
(757) 889-6580
Entity
Organization
Contact information
Practice address
100 KINGSLEY LN STE 300, NORFOLK, VA 23505-4613
(757) 889-6580
(757) 889-6583
Mailing address
100 KINGSLEY LN STE 300, NORFOLK, VA 23505-4613
(757) 889-6580
(757) 889-6583
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101044491
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010140811
—
VA
Enumeration date
05/02/2007
Last updated
01/14/2011
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