Provider Demographics
NPI:1477579738
Name:GREATER WASHINGTON ADVANCED PODIATRY LLC
Entity Type:Organization
Organization Name:GREATER WASHINGTON ADVANCED PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-461-7405
Mailing Address - Street 1:PO BOX 3376
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-3376
Mailing Address - Country:US
Mailing Address - Phone:301-515-3338
Mailing Address - Fax:301-515-6888
Practice Address - Street 1:232 LEE ST N STE D
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-0300
Practice Address - Country:US
Practice Address - Phone:304-520-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01421213ES0103X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5739590001OtherDMERC
MD5739590001OtherDMERC