Provider Demographics
NPI:1467527689
Name:ANKLE AND FOOT ASSOCIATES PC
Entity Type:Organization
Organization Name:ANKLE AND FOOT ASSOCIATES PC
Other - Org Name:ANKLE & FOOT ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MILZA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:207-893-1989
Mailing Address - Street 1:51 SEWALL ST STE 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2644
Mailing Address - Country:US
Mailing Address - Phone:207-761-3889
Mailing Address - Fax:207-761-1874
Practice Address - Street 1:51 SEWALL ST STE 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2644
Practice Address - Country:US
Practice Address - Phone:207-761-3889
Practice Address - Fax:207-761-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME213ES0103X
MEPOD1019207X00000X
MEPOD1073213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEC14101OtherRAIL ROAD MEDICARE
ME0634980001Medicare NSC
MEMM0235Medicare PIN
MELX0482Medicare PIN
MEC14101OtherRAIL ROAD MEDICARE
ME112350001Medicaid
ME112350000Medicaid
ME926000013Medicaid