MEDICARE: METROPOLITAN FAMILY PRACTICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D059182	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679751473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROPOLITAN FAMILY PRACTICE, LLC

Provider Business Mailing Address
First Line	:	3450 FORT MEADE RD
Second Line	:	SUITE 109
City	:	LAUREL
State	:	MD
Zip	:	20724-2040
Country	:	US
Telephone Number	:	301-317-8660
Fax Number	:	301-317-8663

Provider Business Practice Location Address
First Line	:	3450 FORT MEADE RD
Second Line	:	SUITE 109
City	:	LAUREL
State	:	MD
Zip	:	20724-2040
Country	:	US
Telephone Number	:	301-317-8660
Fax Number	:	301-317-8663

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GERREN SHINAR PERRY-FABRIZIO
Credential	:	MD
Telephone Number	:	301-317-8660

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	05/18/2012

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Directions to “METROPOLITAN FAMILY PRACTICE, LLC ” Practice Location

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