MEDICARE: DR. RONALD ALLEN FOOTER D.P.M.

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	213E00000X	Podiatrist	00360	MD

General Provider Information

NPI Number	:	1134106859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD ALLEN FOOTER D.P.M.

Provider Business Mailing Address
First Line	:	16220 S FREDERICK AVE
Second Line	:	SUITE 200
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-4039
Country	:	US
Telephone Number	:	301-948-2995
Fax Number	:	301-948-6056

Provider Business Practice Location Address
First Line	:	16220 S FREDERICK AVE
Second Line	:	SUITE 200
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-4039
Country	:	US
Telephone Number	:	301-948-2995
Fax Number	:	301-948-6056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/08/2007

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