Frederick Family Medical Clinic | |
1709 Rosemont Ave Frederick MD 21702-4135 | |
(301) 624-5999 | |
(301) 624-5997 |
Full Name | Frederick Family Medical Clinic |
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Speciality | Internal Medicine |
Location | 1709 Rosemont Ave, Frederick, Maryland |
Authorized Official Name and Position | Innocent Monya-tambi (OWNER) |
Authorized Official Contact | 3016245999 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Frederick Family Medical Clinic 1709 Rosemont Ave Frederick MD 21702-4135 Ph: (301) 624-5999 | Frederick Family Medical Clinic 1709 Rosemont Ave Frederick MD 21702-4135 Ph: (301) 624-5999 |
NPI Number | 1821585621 |
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Provider Enumeration Date | 04/17/2018 |
Last Update Date | 04/07/2022 |
Medicare PECOS PAC ID | 9335519503 |
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Medicare Enrollment ID | O20230104001139 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821585621 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0076463 (Maryland) | Primary |
Provider Name | Innocent Monya Tambi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1386829679 PECOS PAC ID: 8224263371 Enrollment ID: I20131221000024 |
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