Healthcare Provider Details

I. General information

NPI: 1083760086
Provider Name (Legal Business Name): JAMES S ALBERTOLI MD FACS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 THOMAS JOHNSON DR SUITE 100
FREDERICK MD
21702-4599
US

IV. Provider business mailing address

56 THOMAS JOHNSON DR SUITE 100
FREDERICK MD
21702-4599
US

V. Phone/Fax

Practice location:
  • Phone: 301-698-9999
  • Fax:
Mailing address:
  • Phone: 301-698-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES S ALBERTOLI
Title or Position: MEMBER
Credential: MD
Phone: 301-698-9999