| |
65 Thomas Johnson Dr Ste C Frederick MD 21702-4371 | |
(301) 663-3836 | |
(301) 663-0122 |
Full Name | |
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Speciality | Internal Medicine |
Location | 65 Thomas Johnson Dr Ste C, Frederick, Maryland |
Authorized Official Name and Position | Andrew Oliver Donelson (PARTNER PHYSICIAN) |
Authorized Official Contact | 3016633836 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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65 Thomas Johnson Dr Ste C Frederick MD 21702-4371 Ph: (301) 663-3836 | 65 Thomas Johnson Dr Ste C Frederick MD 21702-4371 Ph: (301) 663-3836 |
NPI Number | 1760590111 |
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Provider Enumeration Date | 08/27/2006 |
Last Update Date | 10/29/2024 |
Medicare PECOS PAC ID | 4789712035 |
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Medicare Enrollment ID | O20100507000311 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760590111 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
Provider Name | Hemen Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821002601 PECOS PAC ID: 2466487897 Enrollment ID: I20051031000335 |
Provider Name | Hirenkumar N Shah |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1093742801 PECOS PAC ID: 4082617691 Enrollment ID: I20060822000309 |
Provider Name | Majd Hakim |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1598871378 PECOS PAC ID: 5395873640 Enrollment ID: I20101023000100 |
Provider Name | Andrew Oliver Donelson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518996495 PECOS PAC ID: 3476681727 Enrollment ID: I20110602000691 |
Hillcrest School Based Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1285 Hillcrest Dr, Frederick, MD 21703 Phone: 240-236-3275 Fax: 240-236-3293 | |
Premise Health Of Maryland Medical P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7407 Willow Rd, Frederick, MD 21702 Phone: 301-624-5270 Fax: 334-625-4520 | |
Premise Health Of Maryland Medical P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9021 Bennett Creek Blvd, Frederick, MD 21704 Phone: 240-346-3549 |