Healthcare Provider Details

I. General information

NPI: 1689168627
Provider Name (Legal Business Name): CHEVY CHASE FOOT & ANKLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 N PARK AVE STE G1N
CHEVY CHASE MD
20815-7516
US

IV. Provider business mailing address

4600 N PARK AVE STE G1N
CHEVY CHASE MD
20815-7516
US

V. Phone/Fax

Practice location:
  • Phone: 240-641-8735
  • Fax: 240-641-8740
Mailing address:
  • Phone: 240-641-8735
  • Fax: 240-641-8740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01623
License Number StateMD

VIII. Authorized Official

Name: NAVID SADOUGHI
Title or Position: OWNER
Credential: MD
Phone: 240-641-8735