Sole Purpose Podiatry, Llc | |
8900 Columbia 100 Pkwy, Columbia, MD 21045-2336 | |
(302) 526-9582 | |
Not Available |
Full Name | Sole Purpose Podiatry, Llc |
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Type | Facility |
Speciality | Podiatrist |
Location | 8900 Columbia 100 Pkwy, Columbia, Maryland |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1366078842 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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213E00000X | Podiatrist | (* (Not Available)) | Primary |
Provider Name | Fanta V Morgan Kitson |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1376756080 PECOS PAC ID: 1456403401 Enrollment ID: I20090722000292 |
Mailing Address | Practice Location Address |
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Sole Purpose Podiatry, Llc Po Box 813, Smyrna, DE 19977-0813 Ph: (302) 526-9582 | Sole Purpose Podiatry, Llc 8900 Columbia 100 Pkwy, Columbia, MD 21045-2336 Ph: (302) 526-9582 |
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