| |
194 Thomas Johnson Dr Frederick MD 21702-4679 | |
(301) 663-3137 | |
(301) 695-6939 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 194 Thomas Johnson Dr, Frederick, Maryland |
Authorized Official Name and Position | Michelle Mahan (SR. VP AND CFO) |
Authorized Official Contact | 2405663355 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
194 Thomas Johnson Dr Frederick MD 21702-4679 Ph: (301) 663-3137 | 194 Thomas Johnson Dr Frederick MD 21702-4679 Ph: (301) 663-3137 |
NPI Number | 1821366493 |
---|---|
Provider Enumeration Date | 12/09/2011 |
Last Update Date | 01/24/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821366493 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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 |