Provider Demographics
NPI:1366201931
Name:MINIMALLY INVASIVE FOOT & ANKLE CENTER LLC
Entity type:Organization
Organization Name:MINIMALLY INVASIVE FOOT & ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:HUMMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-342-8763
Mailing Address - Street 1:6230 OLD DOBBIN LN STE 290
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5884
Mailing Address - Country:US
Mailing Address - Phone:443-831-4884
Mailing Address - Fax:443-441-3004
Practice Address - Street 1:6230 OLD DOBBIN LN STE 290
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5803
Practice Address - Country:US
Practice Address - Phone:703-342-8763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty