MEDICARE: MONTGOMERY FOOT AND ANKLE ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	01072	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH2860	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1003812124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY FOOT AND ANKLE ASSOCIATES

Provider Business Mailing Address
First Line	:	2730 UNIVERSITY BLVD W
Second Line	:	SUITE 1000
City	:	WHEATON
State	:	MD
Zip	:	20902-1905
Country	:	US
Telephone Number	:	301-949-3668
Fax Number	:	301-949-8833

Provider Business Practice Location Address
First Line	:	2730 UNIVERSITY BLVD W
Second Line	:	SUITE 1000
City	:	WHEATON
State	:	MD
Zip	:	20902-1905
Country	:	US
Telephone Number	:	301-949-3668
Fax Number	:	301-949-8833

Authorized Official
Title or Position	:	OWNER
Name	:	ADAM SPECTOR
Credential	:
Telephone Number	:	301-589-8886

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/14/2008

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