Healthcare Provider Details

I. General information

NPI: 1811950207
Provider Name (Legal Business Name): FOOT SURGI-CENTER OF OWINGS MILLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CROSSROADS DRIVE SUITE 410
OWINGS MILLS MD
21117
US

IV. Provider business mailing address

25 CROSSROADS DRIVE SUITE 410
OWINGS MILLS MD
21117
US

V. Phone/Fax

Practice location:
  • Phone: 410-363-2233
  • Fax: 410-363-2235
Mailing address:
  • Phone: 410-363-2233
  • Fax: 410-363-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberA1397
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberA1397
License Number StateMD

VIII. Authorized Official

Name: ERIC L DIAMOND
Title or Position: OWNER
Credential: DPM
Phone: 410-363-2233