Organization
PODIATRY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERBA JEAN ALECK DPM (OWNER)
(757) 399-5621
Entity
Organization
Contact information
Practice address
3511 WESTERN BRANCH BLVD, PORTSMOUTH, VA 23707-3133
(757) 399-5621
(757) 397-5889
Mailing address
3511 WESTERN BRANCH BLVD, PORTSMOUTH, VA 23707-3133
(757) 399-5621
(757) 397-5889
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009332146
—
VA
Enumeration date
09/20/2006
Last updated
03/04/2008
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