Healthcare Provider Details

I. General information

NPI: 1356384713
Provider Name (Legal Business Name): ALLIED FOOT & ANKLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 06/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 STONER AVE STE 105
WESTMINSTER MD
21157-5698
US

IV. Provider business mailing address

295 STONER AVE STE 105
WESTMINSTER MD
21157-5698
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-6800
  • Fax: 410-857-4227
Mailing address:
  • Phone: 410-848-6800
  • Fax: 410-857-4227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number495624002
License Number StateMD

VIII. Authorized Official

Name: JOHN DOUGLAS BUTLER
Title or Position: DIRECTOR OF MEDICINE
Credential: M.D.
Phone: 410-848-6800