| Name | Value |
|---|---|
| PROVIDER TYPE | Podiatric Medicine & Surgery Service Providers |
| CLASSIFICATION | Resident, Podiatrist |
| DEFINITION | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| STATUS | Active |
| VA CODE | V120213 |
| X12 CODE | 390200000X |
| SPECIALTY CODE | 48 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5255042 |
| EFFECTIVE DATE/TIME |
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