IndividualActive
John Koucheravy, C PED
NPI 1699245365 · Pedorthist · Rockville, MD
Provider details
- NPI number
- 1699245365
- Entity type
- Individual
- Primary specialty
- PedorthistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- C PED
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1643 Rockville Pike Unit B
Rockville, MD 20852-7601
Phone: (301) 811-3121
Approximate (ZIP-level) locationGet directions
Mailing address
1621 Quail Run
Charlottesville, VA 22911-9054
Registry dates
- Enumerated
- 2018-11-26
- Last updated
- 2018-11-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.