Healthcare Provider Details

I. General information

NPI: 1437354503
Provider Name (Legal Business Name): ADERINTO FOOTANKLE ASSOCIATE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EASTERN AVE SUITE # 103
FAIRMOUNT HEIGHTS MD
20743-6500
US

IV. Provider business mailing address

PO BOX 91562
WASHINGTON DC
20090-1562
US

V. Phone/Fax

Practice location:
  • Phone: 301-925-8007
  • Fax: 301-574-4165
Mailing address:
  • Phone: 301-925-8007
  • Fax: 301-574-4165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ADEWALE S ADERINTO
Title or Position: PRESIDENT
Credential: DPM
Phone: 301-925-8007