Healthcare Provider Details

I. General information

NPI: 1093134249
Provider Name (Legal Business Name): MEDPSYCH HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 GUILFORD DR SUITE 100
FREDERICK MD
21704-5193
US

IV. Provider business mailing address

7101 GUILFORD DR SUITE 100
FREDERICK MD
21704-5193
US

V. Phone/Fax

Practice location:
  • Phone: 240-464-8000
  • Fax:
Mailing address:
  • Phone: 240-464-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0002X
TaxonomyObesity Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MANDEEP SINGH
Title or Position: COO
Credential:
Phone: 240-464-8000