Organization
CAPITAL FOOT & ANKLE CARE CENTRE, PA
Active
Parent organization
CAPITAL FOOT & ANKLE CARE CENTRE, PA
Other names
Leonardtown Foot & Ankle
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAPITAL FOOT & ANKLE CARE CENTRE, PA
Authorized official
DR. ROBERT LOUIS VANFOSSON D.P.M. (PRESIDENT)
(301) 862-3338
Entity
Organization
Contact information
Practice address
22680 CEDAR LANE CT OFC 2, LEONARDTOWN, MD 20650-3910
(301) 862-3338
(301) 862-3335
Mailing address
PO BOX 1310, CALIFORNIA, MD 20619-1310
(301) 862-3338
(301) 862-3335
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
00975
MD
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
01346
MD
213ES0103X
Foot & Ankle Surgery Podiatrist
01511
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231308100
—
MD
01
—
77230001
BLUE CROSS BLUE SHIELD
MD
Enumeration date
10/28/2013
Last updated
10/28/2013
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