Individual
DAVID MARK GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
604 SOLAREX CT, UNIT 103, FREDERICK, MD 21703-8678
(301) 698-9260
(301) 698-8962
Mailing address
1600 E GUDE DR, SUITE 200, ROCKVILLE, MD 20850-1341
(301) 933-7133
(301) 933-7137
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01249
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431710600
—
MD
01
—
480030745
MEDICARE RAILROAD
MD
01
—
54664503
BLUE CROSS
MD
01
—
6359 0001
BLUE CHOICE
MD
Enumeration date
03/16/2006
Last updated
11/28/2018
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