Healthcare Provider Details

I. General information

NPI: 1982354320
Provider Name (Legal Business Name): JAMES THOMAS ANSELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMIE ANSELL MD

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

400 W 7TH ST
FREDERICK MD
21701-4506
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3300
  • Fax:
Mailing address:
  • Phone: 240-566-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0106773
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2025-03680
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: