Provider Type Icon

DIVINE PODIATRY CENTER LLC NPI 1528530268


NPI Information

NPI: 1528530268
Provider Name: DIVINE PODIATRY CENTER LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
1204 BENTLEY ESTATES DR
DACULA, GA
ZIP 30019
Phone: (609) 922-8166
Get Directions

DIVINE PODIATRY CENTER LLC is a podiatrist in Dacula, GA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DIVINE PODIATRY CENTER LLC NPI is 1528530268. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1204 BENTLEY ESTATES DR
DACULA, GA
ZIP 30019-786
Phone: (609) 922-8166

The provider's authorized official is Aliya Matthews .
The authorized official title is Owner and has the following contact phone number (609) 922-1866.

The enumeration date for this NPI number is 12/19/2018 and was last updated on 4/18/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.