Organization Name: | PODIATRY GROUP, P.A. |
NPI Number: | 1487778528 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN MICHELLE HEIZER (OFFICE MANAGER) |
Mailing Address: | 2401 Brandermill Blvd Ste 340 Gambrills |
State: | MD US |
Postal Code: | 210541690 |
Phone Number: | 4104513206 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 02/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |