Provider Demographics
NPI:1982958286
Name:JOYCE LEWIS PODIATRY ASSOCIATES LLC
Entity type:Organization
Organization Name:JOYCE LEWIS PODIATRY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-795-2155
Mailing Address - Street 1:826 WASHINGTON RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5750
Mailing Address - Country:US
Mailing Address - Phone:410-861-5092
Mailing Address - Fax:
Practice Address - Street 1:1010 LIBERTY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7949
Practice Address - Country:US
Practice Address - Phone:410-795-2155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01503332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4575960004Medicare NSC