Healthcare Provider Details

I. General information

NPI: 1477556173
Provider Name (Legal Business Name): FREDERICK H. GUCKES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEDICAL PKWY STE 304
ANNAPOLIS MD
21401-3745
US

IV. Provider business mailing address

2000 MEDICAL PKWY STE 409
ANNAPOLIS MD
21401-3746
US

V. Phone/Fax

Practice location:
  • Phone: 410-573-9530
  • Fax: 410-573-9569
Mailing address:
  • Phone: 672-047-2126
  • Fax: 443-481-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VC0200X
TaxonomyCritical Care Medicine (Obstetrics & Gynecology) Physician
License NumberD0052857
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0052857
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: