Provider Demographics
NPI:1003926122
Name:TRITTO, MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:TRITTO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1600 E GUDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1341
Mailing Address - Country:US
Mailing Address - Phone:301-933-7133
Mailing Address - Fax:301-933-7137
Practice Address - Street 1:11801 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2734
Practice Address - Country:US
Practice Address - Phone:301-881-6222
Practice Address - Fax:301-881-1639
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD01107213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD781918801Medicaid
MD781918801Medicaid
DC4277200001Medicare NSC
DC6612640001Medicare NSC
DC696744YFCTMedicare PIN