Provider Demographics
NPI:1013918630
Name:SALISBURY FOOT & ANKLE CENTER PA
Entity Type:Organization
Organization Name:SALISBURY FOOT & ANKLE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-749-6363
Mailing Address - Street 1:106 MILFORD ST
Mailing Address - Street 2:STE 403
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6953
Mailing Address - Country:US
Mailing Address - Phone:410-749-6363
Mailing Address - Fax:410-546-1463
Practice Address - Street 1:106 MILFORD ST
Practice Address - Street 2:STE 403
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6953
Practice Address - Country:US
Practice Address - Phone:410-749-6363
Practice Address - Fax:410-546-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-04
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01253213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
450845OtherMAMSI
MDT468OtherBLUE CROSS/BLUE SHIELD
MD480029665OtherMEDICARE RAILROAD
MDDQ5633OtherMEDICARE RAILROAD
5283530OtherAETNA
MD480029665OtherMEDICARE RAILROAD
MD235RMedicare ID - Type Unspecified
450845OtherMAMSI
MD480029665Medicare PIN