Provider Demographics
NPI:1972170892
Name:FIRST CHOICE PODIATRY LLC
Entity type:Organization
Organization Name:FIRST CHOICE PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:484-686-8861
Mailing Address - Street 1:107 RIDGELY AVE STE 13A
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1417
Mailing Address - Country:US
Mailing Address - Phone:443-332-2300
Mailing Address - Fax:443-332-2301
Practice Address - Street 1:107 RIDGELY AVE STE 13A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1417
Practice Address - Country:US
Practice Address - Phone:443-332-2300
Practice Address - Fax:443-332-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric