Healthcare Provider Details

I. General information

NPI: 1679566228
Provider Name (Legal Business Name): AMBULATORY FOOT AND ANKLE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 INTERNATIONAL DR SUITE 204
SILVER SPRING MD
20906-1550
US

IV. Provider business mailing address

3801 INTERNATIONAL DR SUITE 204
SILVER SPRING MD
20906-1550
US

V. Phone/Fax

Practice location:
  • Phone: 301-598-0130
  • Fax: 301-598-5091
Mailing address:
  • Phone: 301-598-0130
  • Fax: 301-598-5091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA1260
License Number StateMD

VIII. Authorized Official

Name: DR. DAVID J FREEDMAN
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: DPM
Phone: 301-598-0130