| Organization Name: | CROSSROADS PODIATRIC SURGERY CENTER, L.L.C. |
| NPI Number: | 1003912957 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIKEL D DANIELS (DIRECTOR) |
| Mailing Address: | 20 Crossroads Dr Suite 15 Owings Mills |
| State: | MD US |
| Postal Code: | 211175419 |
| Phone Number: | 4103634343 |
| Fax Number: | 4103566373 |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 01/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |