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General NPI Number Information
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NPI Number | 1205941192
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Entity Type | Organization
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Legal Business Name | MIRKIN FOOT ASSOCIATES PA
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 11/24/2011
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Provider Practice Location Address
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Address Line | 10901 CONNECTICUT AVE SUITE 200
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City | KENSINGTON
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State | MD
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Zip | 20895-1645
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Country | US
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Telephone | 301-949-2000
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Fax | 301-949-2002
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Provider Business Mailing Address
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Address Line | 2415 MUSGROVE RD SUITE 103
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City | SILVER SPRING
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State | MD
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Zip | 20904-5200
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Country | US
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Telephone | 301-384-6500
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Fax | 301-384-6670
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Authorized Official
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Title or Position | PRESIDENT
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Name | GENE S MIRKIN
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Credential | DPM
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Telephone | 301-949-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | MD
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