NPI 1104194778

Frederick Health Medical Group LLC

Organisation Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Frederick, MD

Practice location

Address: 1562 Opossumtown Pike, Frederick, MD 21702-4337
Phone: (301) 694-5861
Fax: (301) 694-0927
Mailing address: 501 W 7th St, Frederick, MD 21701-4586

Authorised official

Name: Michelle Mahan
Title: Sr Vp and Cfo
Phone: (240) 566-3355

Registered specialties

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208G00000X

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Registry record

NPI: 1104194778
Entity type: Organization
NPI issued: 9 Dec 2011
Record last updated: 24 Jan 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.