| Internal Medicine Specialists Of Frederick | |
|
85 Thomas Johnson Ct Suite C Frederick MD 21702 | |
| (301) 668-9393 | |
| (301) 668-4480 |
| Full Name | Internal Medicine Specialists Of Frederick |
|---|---|
| Speciality | Internal Medicine |
| Location | 85 Thomas Johnson Ct, Frederick, Maryland |
| Authorized Official Name and Position | Tyra D Kane (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3016689393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Specialists Of Frederick 85 Thomas Johnson Ct, Suite C Frederick MD 21702 Ph: (301) 668-9393 | Internal Medicine Specialists Of Frederick 85 Thomas Johnson Ct Suite C Frederick MD 21702 Ph: (301) 668-9393 |
| NPI Number | 1740436245 |
|---|---|
| Provider Enumeration Date | 08/15/2008 |
| Last Update Date | 10/18/2017 |
| Medicare PECOS PAC ID | 5193889822 |
|---|---|
| Medicare Enrollment ID | O20090126000188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740436245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tyra D Kane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639102924 PECOS PAC ID: 8628046851 Enrollment ID: I20041204000219 |
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