Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. STANLEY IDICULLA, DPM
ActiveDR. STANLEY IDICULLA, DPM is a Foot Surgery Podiatrist healthcare provider located in HERNDON, Virginia. NPI 1043274368 is currently active in the NPPES registry. Verify at CMS.
Foot Surgery Podiatrist · HERNDON, VA
Registration Details
- NPI Number
- 1043274368
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 13, 2006 (20.364888684462 yrs)
- Last Updated
- Dec 18, 2013
- License
-
XXXX (VA)
Practice Information
- Address
-
112 ELDEN STSUITE DHERNDON, VA, 201704874Browse VA providers · Browse ZIP 20170
- Phone
- 7034375353
- Primary Specialty
-
Foot Surgery Podiatrist
213ES0131X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.