Doctor Name: | DR. JOHN P MIKETA |
NPI Number: | 1013138528 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 337 |
Business Practice Address: | 122 North Main St Fuquay Varina, NC - 275261933 |
Business Phone Number: | 9195575148 |
Business Fax Number: | 9195575645 |
Mailing Address: | 122 North Main St, FUQUAY VARINA |
State: | NC |
Postal Code: | 275261933 |
Phone Number: | 9195575148 |
Fax Number: | 9195575645 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 08/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 337 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |