Provider Demographics
NPI:1356384713
Name:ALLIED FOOT & ANKLE PC
Entity type:Organization
Organization Name:ALLIED FOOT & ANKLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-848-6800
Mailing Address - Street 1:295 STONER AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5698
Mailing Address - Country:US
Mailing Address - Phone:410-848-6800
Mailing Address - Fax:410-857-4227
Practice Address - Street 1:295 STONER AVE
Practice Address - Street 2:STE 105
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5698
Practice Address - Country:US
Practice Address - Phone:410-848-6800
Practice Address - Fax:410-857-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD495624002332B00000X
213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDC8924OtherMEDICARE RAILROAD
PA001537842OtherBC OF PA
PA1009955610001Medicaid
MD547153OtherUNITED HEALTHCARE
MD241AALOtherBLUE CROSS OF MD
PA50027549OtherBC PA CAPITAL CARE
MD404398700Medicaid
DCJ239OtherBC DC/METRO
MD404398700Medicaid
MD547153OtherUNITED HEALTHCARE
PA50027549OtherBC PA CAPITAL CARE