Provider Demographics
NPI:1841765310
Name:FREDERICK FOOT AND ANKLE SPECIALISTS
Entity Type:Organization
Organization Name:FREDERICK FOOT AND ANKLE SPECIALISTS
Other - Org Name:FREDERICK FOOT AND ANKLE OF MARTINSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YENISEY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-668-9707
Mailing Address - Street 1:141 THOMAS JOHNSON DR STE 170
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4530
Mailing Address - Country:US
Mailing Address - Phone:301-668-9707
Mailing Address - Fax:301-668-4927
Practice Address - Street 1:123 HEALTH CARE LN
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-4008
Practice Address - Country:US
Practice Address - Phone:877-668-0008
Practice Address - Fax:301-668-4927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies