Healthcare Provider Details
I. General information
NPI: 1275448417
Provider Name (Legal Business Name): PROGRESSIVE FEET LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13934 BALTIMORE AVE UNIT 9
LAUREL MD
20707-5000
US
IV. Provider business mailing address
6130 OXON HILL RD STE 305
OXON HILL MD
20745-3168
US
V. Phone/Fax
- Phone: 301-567-5005
- Fax:
- Phone: 301-567-5005
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARASH
ARI
CHANGIZI
Title or Position: CEO
Credential:
Phone: 301-567-5005