Provider Demographics
NPI:1538933403
Name:S. W. PODIATRY GROUP
Entity type:Organization
Organization Name:S. W. PODIATRY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-WINTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:240-200-1386
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-0879
Mailing Address - Country:US
Mailing Address - Phone:443-690-9035
Mailing Address - Fax:
Practice Address - Street 1:177 SAINT PATRICKS DR STE 101
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-5533
Practice Address - Country:US
Practice Address - Phone:240-303-2901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty