Basic Information
Provider Information
NPI: 1750344909
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMINIO
FirstName: STEVEN
MiddleName: T
NamePrefix:  
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 CIRCLE 75 PKWY SE
Address2: STE. 900
City: ATLANTA
State: GA
PostalCode: 303393035
CountryCode: US
TelephoneNumber: 6784262171
FaxNumber: 4044461957
Practice Location
Address1: 11459 JOHNS CREEK PKWY
Address2: STE. 260
City: JOHNS CREEK
State: GA
PostalCode: 300973515
CountryCode: US
TelephoneNumber: 7702325030
FaxNumber: 7704959993
Other Information
ProviderEnumerationDate: 04/10/2006
LastUpdateDate: 01/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000XPOD000451GAY Podiatric Medicine & Surgery Service ProvidersPodiatrist 

No ID Information.


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