Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 0130000659 | VA |
N | 222Z00000X | Podiatrist | 0130000659 | VA |
N | 213EP1101X | Primary Podiatric Medicine | 0130000659 | VA |
N | 2081S0010X | Sports Medicine | 0130000659 | VA |
N | 213ES0000X | Sports Medicine | 0130000659 | VA |
Y | 213ES0103X | Foot & Ankle Surgery | 0130000659 | VA |
NPI | 1295702108 |
---|---|
Provider Name | Steven R Vetter |
First Address | Fairfax, VA 22030-6914 |
Second Address | Fairfax, VA 22030-6914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 03/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31201 | (02) | VA |