Organization
SHADY GROVE PODIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD ALLEN FOOTER D.P.M. (MANAGING PARTNER)
(301) 948-2995
Entity
Organization
Contact information
Practice address
16220 S FREDERICK AVE, SUITE 427, GAITHERSBURG, MD 20877-4039
(301) 948-2995
(301) 948-6056
Mailing address
16220 S FREDERICK AVE, SUITE 427, GAITHERSBURG, MD 20877-4039
(301) 948-2995
(301) 948-6056
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00360
MD
Other
Enumeration date
03/22/2007
Last updated
09/13/2011
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