Healthcare Provider Details

I. General information

NPI: 1306644190
Provider Name (Legal Business Name): HOSPITALIST MEDICINE PHYSICIANS OF MARYLAND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 ROSEMONT AVE
FREDERICK MD
21702-8249
US

IV. Provider business mailing address

120 BRENTWOOD COMMONS WAY
BRENTWOOD TN
37027-2023
US

V. Phone/Fax

Practice location:
  • Phone: 240-772-9200
  • Fax:
Mailing address:
  • Phone: 253-682-6040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA FALL
Title or Position: PAYER ENROLLMENT MANAGER
Credential:
Phone: 253-682-6040