| Poolesville Family Practice | |
|
19710 Fisher Ave Suite J Poolesville MD 20837-2098 | |
| (301) 972-7600 | |
| Not Available |
| Full Name | Poolesville Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 19710 Fisher Ave, Poolesville, Maryland |
| Authorized Official Name and Position | Kathleen J Kautz (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3019727600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Poolesville Family Practice Po Box 108 Poolesville MD 20837-0108 Ph: (301) 972-7600 | Poolesville Family Practice 19710 Fisher Ave Suite J Poolesville MD 20837-2098 Ph: (301) 972-7600 |
| NPI Number | 1033142393 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033142393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D38076 (Maryland) | Primary |
Poolesville Family Practice Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19710 Fisher Ave, Suite J, Poolesville, MD 20837 Phone: 301-972-7600 Fax: 301-972-8006 |