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Organization

DRS. LISS & MIRKIN, P.A. T/A FOOT & ANKLE ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENE S MIRKIN DPM (MEDICAL DIRECTOR OWNER)
(301) 949-2000
Entity
Organization

Contact information

Practice address
10901 CONNECTICUT AVENUE, #200, KENSINGTON, MD 20895
(301) 949-2000
(301) 949-2002
Mailing address
10901 CONNECTICUT AVE, #200, KENSINGTON, MD 20895-1645
(301) 949-2000
(301) 949-2002

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1081
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21C0001081
HIXA
MD
Enumeration date
01/27/2006
Last updated
09/04/2008
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