Organization · Type 2 NPI
Gracemprincetorain DPM
Foot Surgery Podiatrist · Odenton, MD
NPI number
1164640355
Active
Practice location
8379 Piney Orchard Pkwy, D
Odenton, MD 21113-1508
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot Surgery Podiatrist Primary | 213ES0131X | 01416 (MD) |
Foot Surgery Podiatrist: Definition to come...
2 other providers at this address
About NPI 1164640355
Gracemprincetorain DPM's National Provider Identifier is 1164640355, issued on Apr 23, 2007. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in Odenton, MD. The record was last updated on Jun 25, 2008.