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General NPI Number Information
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NPI Number | 1831379072
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Entity Type | Organization
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Legal Business Name | CAPITOL FOOT & ANKLE, LLC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 4701 RANDOLPH RD #115
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City | ROCKVILLE
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State | MD
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Zip | 20852-2257
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Country | US
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Telephone | 703-578-3899
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Fax | 703-578-8950
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Provider Business Mailing Address
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Address Line | 5256 DAWES AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1404
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Country | US
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Telephone | 703-578-3899
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Fax | 703-578-8950
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. MELISSA O SMITH
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Credential | D.P.M.
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Telephone | 703-578-3899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 01382
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License Number State | MD
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