Provider Demographics
NPI:1790169746
Name:MARYLAND PODIATRY PA
Entity Type:Organization
Organization Name:MARYLAND PODIATRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-660-8841
Mailing Address - Street 1:6821 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1431
Mailing Address - Country:US
Mailing Address - Phone:410-660-8841
Mailing Address - Fax:410-982-6929
Practice Address - Street 1:6821 REISTERSTOWN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1431
Practice Address - Country:US
Practice Address - Phone:410-660-8841
Practice Address - Fax:410-982-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies