| Menocal Medical Services Pa | |
|
110 Baughmans Ln Suite 140 Frederick MD 21702-4059 | |
| (240) 215-1138 | |
| (240) 215-1140 |
| Full Name | Menocal Medical Services Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 110 Baughmans Ln, Frederick, Maryland |
| Authorized Official Name and Position | Julio Jose Menocal (PRESIDENT) |
| Authorized Official Contact | 2402151138 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Menocal Medical Services Pa Po Box 1149 Frederick MD 21702-0149 Ph: () - | Menocal Medical Services Pa 110 Baughmans Ln Suite 140 Frederick MD 21702-4059 Ph: (240) 215-1138 |
| NPI Number | 1083795918 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 08/11/2014 |
| Medicare PECOS PAC ID | 1951405216 |
|---|---|
| Medicare Enrollment ID | O20070327000511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083795918 | NPI | - | NPPES |
| 532403300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D31912 (Maryland) | Primary |
| Provider Name | Julio Menocal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164492401 PECOS PAC ID: 6103920368 Enrollment ID: I20070327000638 |
| Provider Name | Mohammed S Ali |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1083783872 PECOS PAC ID: 9133350721 Enrollment ID: I20140325000346 |
| Provider Name | Carolyn Roetering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265501001 PECOS PAC ID: 8628152725 Enrollment ID: I20141013000076 |
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