Healthcare Provider Details

I. General information

NPI: 1245402767
Provider Name (Legal Business Name): FAMILY FOOT & ANKLE ASSOCIATES OF MARYLAND, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 LOCKWOOD DR STE 260
SILVER SPRING MD
20901-1559
US

IV. Provider business mailing address

3408 OLANDWOOD COURT SUITE 226
OLNEY MD
20832-1513
US

V. Phone/Fax

Practice location:
  • Phone: 301-439-0300
  • Fax: 301-681-1488
Mailing address:
  • Phone: 301-924-5044
  • Fax: 301-924-5933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHARON COHEN
Title or Position: MANAGER
Credential:
Phone: 301-924-5044