Provider Demographics
NPI:1427167923
Name:PODIATRY GROUP OF ANNAPOLIS PA
Entity type:Organization
Organization Name:PODIATRY GROUP OF ANNAPOLIS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-224-4448
Mailing Address - Street 1:139 OLD SOLOMONS ISLAND ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-0902
Mailing Address - Country:US
Mailing Address - Phone:410-224-4448
Mailing Address - Fax:410-841-5200
Practice Address - Street 1:139 OLD SOLOMONS ISLAND ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-0902
Practice Address - Country:US
Practice Address - Phone:410-224-4448
Practice Address - Fax:443-949-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
22570000OtherFEP
338839OC2OtherOPTIMUM CHOICE
339839MD2OtherMDIPA
339839ML2OtherMAMSI LIFE AND HEALTH
7076126OtherAETNA TRADITIONAL
22570000OtherGHMSI
345024PPOOtherNCPPO
7582764OtherCIGNA
2329307OtherAETNA HMO
MD204300900Medicaid
C341QOtherUNITED AMERICAN
LU50POOtherCAREFIRST BLUECROSS BLUES
3938140001OtherADMINISTAR FEDERAL INC
338839OC2OtherOPTIMUM CHOICE
=========OtherGEHA
=========OtherCONNECTICUT GENERAL
=========OtherFIDELITY BENEFITS
=========OtherMAIL HANDLERS
339839MD2OtherMDIPA
=========OtherFIDELITY BENEFITS
=========OtherMAIL HANDLERS