Provider Demographics
NPI:1245668060
Name:SOFFER FOOT AND ANKLE CARE, LLC
Entity type:Organization
Organization Name:SOFFER FOOT AND ANKLE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:SOFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-775-4000
Mailing Address - Street 1:110 HOSPITAL RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4019
Mailing Address - Country:US
Mailing Address - Phone:410-775-4000
Mailing Address - Fax:
Practice Address - Street 1:110 HOSPITAL RD
Practice Address - Street 2:SUITE 215
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4019
Practice Address - Country:US
Practice Address - Phone:410-775-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01525261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric