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Organization

LEONARD WISOTSKY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEONARD WISOTSKY D.P.M. (OWNER/PODIATRIST)
(301) 567-5005
Entity
Organization

Contact information

Practice address
6188 OXON HILL RD, SUITE 804, OXON HILL, MD 20745-3113
(301) 567-5005
(301) 839-5677
Mailing address
6188 OXON HILL RD, SUITE 804, OXON HILL, MD 20745-3113
(301) 567-5005
(301) 839-5677

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08378
AMERIGROUP
MD
01
27496
PRIORITY PARTNERS
MD
01
P00152532
RAILROAD MEDICARE
MD
Enumeration date
03/13/2008
Last updated
03/13/2008
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