Individual
DR. M LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1217 CURRY RD, ROTTERDAM, NY 12306-3707
(518) 355-0043
(518) 355-0053
Mailing address
1217 CURRY RD, ROTTERDAM, NY 12306-3707
(518) 355-0043
(518) 355-0053
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
SC005680
PA
213ES0131X
Foot Surgery Podiatrist
Primary
006165
NY
Other
Enumeration date
08/04/2006
Last updated
11/30/2009
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