Provider Demographics
NPI:1871979724
Name:GREENE TREE FOOT/ANKLE SURGICENTER, LLC
Entity type:Organization
Organization Name:GREENE TREE FOOT/ANKLE SURGICENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:443-830-0053
Mailing Address - Street 1:405 FREDERICK RD
Mailing Address - Street 2:SUITE 162
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4645
Mailing Address - Country:US
Mailing Address - Phone:443-830-0053
Mailing Address - Fax:443-830-0057
Practice Address - Street 1:1838 GREENE TREE RD
Practice Address - Street 2:SUITE 430
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-6391
Practice Address - Country:US
Practice Address - Phone:410-602-8637
Practice Address - Fax:410-602-9781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical