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General NPI Number Information
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NPI Number | 1497147557
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Entity Type | Organization
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Legal Business Name | LAUREL FOOT AND ANKLE CENTER
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Dates
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Enumeration Date | 02/26/2015
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Last Update Date | 03/01/2015
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Provider Practice Location Address
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Address Line | 14440 CHERRY LANE CT SUITE 101
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City | LAUREL
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State | MD
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Zip | 20707-4946
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Country | US
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Telephone | 301-953-3668
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Fax | 301-953-3854
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Provider Business Mailing Address
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Address Line | 14440 CHERRY LANE CT SUITE 101
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City | LAUREL
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State | MD
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Zip | 20707-4946
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Country | US
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Telephone | 301-953-3668
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Fax | 301-953-3854
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MICHAEL A KLEIN
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Credential | D. P. M.
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Telephone | 240-447-3867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 01302
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License Number State | MD
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