Organization
CAROLINA FAMILY FOOT CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P MIKETA DPM (OWNER)
(919) 557-5148
Entity
Organization
Contact information
Practice address
122 NORTH MAIN STREET, FUQUAY VARINA, NC 27526-1933
(919) 557-5148
Mailing address
122 NORTH MAIN ST, FUQUAY VARINA, NC 27526-1933
(919) 557-5148
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909182
—
NC
Enumeration date
05/17/2007
Last updated
08/05/2008
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