Healthcare Provider Details

I. General information

NPI: 1447233234
Provider Name (Legal Business Name): GERARD DELGRIPPO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 THOMAS JOHNSON DR SUITE E
FREDERICK MD
21702-4384
US

IV. Provider business mailing address

610 SOLAREX CT
FREDERICK MD
21703-8624
US

V. Phone/Fax

Practice location:
  • Phone: 301-694-7600
  • Fax: 301-228-2500
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0041994
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: