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Organization
POTOMAC PODIATRY PLLC
Active
Organization
POTOMAC PODIATRY PLLC
Active
Parent organization
POTOMAC PODIATRY PLLC
Other names
Crofton Podiatry
Organization subpart
Yes
Provider details
NPI number
Legal business name
POTOMAC PODIATRY PLLC
Authorized official
VINCENT JOSEPH BONINI DPM (OWNER)
(301) 200-3040
Entity
Organization
Contact information
Practice address
1657 CROFTON BLVD STE 201, CROFTON, MD 21114-1352
(410) 721-4505
Mailing address
14010 SMOKETOWN RD STE 103, WOODBRIDGE, VA 22192-4723
(703) 583-5959
(703) 583-5995
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
06/11/2021
Last updated
11/05/2021
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