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General NPI Number Information
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NPI Number | 1497089304
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Entity Type | Organization
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Legal Business Name | CATONSVILLE FOOT & ANKLE
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/24/2009
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Provider Practice Location Address
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Address Line | 109 OSBORNE AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-4937
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Country | US
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Telephone | 410-719-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 109 OSBORNE AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-4937
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Country | US
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Telephone | 410-719-2334
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARON T SIEBOLD
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Credential | DPM
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Telephone | 410-719-2334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 01290
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License Number State | MD
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