Healthcare Provider Details

I. General information

NPI: 1114196235
Provider Name (Legal Business Name): JANICE POSTAL DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11125 ROCKVILLE PIKE STE 203
ROCKVILLE MD
20852-3142
US

IV. Provider business mailing address

11125 ROCKVILLE PIKE STE 203
ROCKVILLE MD
20852-3142
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-6008
  • Fax: 301-681-8908
Mailing address:
  • Phone: 301-681-6008
  • Fax: 301-681-8908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANICE POSTAL
Title or Position: OWNER
Credential: DPM
Phone: 301-681-6008