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Podiatric Medicine & Surgery Service Providers Podiatrist

Provider NPI: 1669427472

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 410-764-7044  Fax: 410-764-8637

Business Mailing Address:
Tel: 410-764-7044  Fax: 410-764-8637

NPI Information:
NPI: 1669427472
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y213E00000XPodiatric Medicine & Surgery Service Providers
N213EP0504XPodiatric Medicine & Surgery Service Providers
N213EP1101XPodiatric Medicine & Surgery Service Providers
N213ER0200XPodiatric Medicine & Surgery Service Providers
N213ES0000XPodiatric Medicine & Surgery Service Providers
N213ES0103XPodiatric Medicine & Surgery Service Providers
N213ES0131XPodiatric Medicine & Surgery Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 213E00000X





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