Healthcare Provider Details
I. General information
NPI: 1861575219
Provider Name (Legal Business Name): FOOT AND ANKLE SURGERY CENTER OF SILVER SPRING, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8505 FENTON ST SUITE 200
SILVER SPRING MD
20910-4497
US
IV. Provider business mailing address
8505 FENTON ST SUITE 200
SILVER SPRING MD
20910-4497
US
V. Phone/Fax
- Phone: 301-589-7663
- Fax: 301-589-3410
- Phone: 301-589-7663
- Fax: 301-589-3410
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | A1401 |
| License Number State | MD |
VIII. Authorized Official
Name: DR.
BRUCE
TODD
FOX
Title or Position: PRESIDENT
Credential: DPM
Phone: 301-589-7663