| NPI | 1104001619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SCOTT RIEDER Doctor Of Podiatric Medicine 443-413-5640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MD 01116) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MD 01116) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2008-02-13 |