Organization
THE PODIATRY CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RHONDA LYNN NELSON D.P.M. (OWNER)
(301) 352-3668
Entity
Organization
Contact information
Practice address
12150 ANNAPOLIS RD, SUITE 109, GLENN DALE, MD 20769-9179
(301) 352-3668
(301) 352-3669
Mailing address
12150 ANNAPOLIS RD, SUITE 109, GLENN DALE, MD 20769-9179
(301) 352-3668
(301) 352-3669
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01318
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134103100
—
MD
01
—
5394560001
DMERC PIN
MD
01
—
583402
MAMSI/MDIPA/OPT CHOICE
MD
01
—
62204301
BLUECROSS AND BLUESHIELD
MD
01
—
7294202
AETNA
MD
01
—
86546
AMERIGROUP
MD
01
—
DF6331
PALMETTO GBA - RAILROAD MEDICARE
MD
01
—
J2590001
BLUECROSS AND BLUESHIELD
MD
Enumeration date
10/15/2007
Last updated
08/09/2013
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