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General NPI Number Information
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NPI Number | 1871655381
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Entity Type | Organization
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Legal Business Name | RECONSTRUCTIVE FOOT & ANKLE INSTITUTE, LLC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 1150 PROFESSIONAL CT SUITE C
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5852
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Country | US
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Telephone | 301-797-8554
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Fax | 301-797-8281
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Provider Business Mailing Address
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Address Line | PO BOX 269
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City | FREDERICK
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State | MD
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Zip | 21705-0269
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Country | US
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Telephone | 301-797-8554
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Fax | 301-797-9228
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL DALE MICHAELS
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Credential | DPM
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Telephone | 301-797-8554
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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 |
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License Number State |
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