Provider Demographics
NPI:1497089304
Name:CATONSVILLE FOOT & ANKLE
Entity Type:Organization
Organization Name:CATONSVILLE FOOT & ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:T
Authorized Official - Last Name:SIEBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-719-2334
Mailing Address - Street 1:109 OSBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4937
Mailing Address - Country:US
Mailing Address - Phone:410-719-2334
Mailing Address - Fax:
Practice Address - Street 1:109 OSBORNE AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4937
Practice Address - Country:US
Practice Address - Phone:410-719-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01290261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric