Healthcare Provider Details

I. General information

NPI: 1992946271
Provider Name (Legal Business Name): MEDICAL HEALTH CENTER OF FREDERICK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 THOMAS JOHNSON DR SUITE #105
FREDERICK MD
21702-4305
US

IV. Provider business mailing address

186 THOMAS JOHNSON DR SUITE #105
FREDERICK MD
21702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-0967
  • Fax: 301-662-0621
Mailing address:
  • Phone: 301-662-0967
  • Fax: 301-662-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HARPAL SINGH MANGAT
Title or Position: PHYSICIAN/OWNER
Credential:
Phone: 301-662-0967