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Organization

CAROLINA FAMILY FOOT CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN P MIKETA DPM (OWNER)
(919) 557-5148
Entity
Organization

Contact information

Practice address
3396 SIX FORKS RD, RALEIGH, NC 27609-7233
(919) 782-8124
(919) 557-5645
Mailing address
122 N MAIN ST, FUQUAY VARINA, NC 27526-1934
(919) 557-5148
(919) 557-5645

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
5950035
NC
Enumeration date
04/24/2008
Last updated
08/05/2008
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