Provider Demographics
NPI:1609380989
Name:PROGRESSIVE FEET LLC
Entity Type:Organization
Organization Name:PROGRESSIVE FEET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:ARI
Authorized Official - Last Name:CHANGIZI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-567-5005
Mailing Address - Street 1:6130 OXON HILL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3168
Mailing Address - Country:US
Mailing Address - Phone:301-567-5005
Mailing Address - Fax:301-839-5677
Practice Address - Street 1:6130 OXON HILL RD STE 305
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3168
Practice Address - Country:US
Practice Address - Phone:301-567-5005
Practice Address - Fax:301-839-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-26
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213ES0103X
MD01608213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty