Healthcare Provider Details

I. General information

NPI: 1306910310
Provider Name (Legal Business Name): GROMAN & RUBIN DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 UNIVERSITY BLVD W SUITE 110
SILVER SPRING MD
20901-1948
US

IV. Provider business mailing address

18111 PRINCE PHILIP DR 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 TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number261QA1903X
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA1189
License Number StateMD

VIII. Authorized Official

Name: DR. CHRISTOPHER PAUL FARNWORTH
Title or Position: CO-OWNER
Credential: DPM
Phone: 301-924-5044