Healthcare Provider Details

I. General information

NPI: 1427194695
Provider Name (Legal Business Name): STEVEN NAGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 THOMAS JOHNSON DR SUITE 4
FREDERICK MD
21702-4863
US

IV. Provider business mailing address

15225 PARTNERSHIP RD
POOLESVILLE MD
20837-8606
US

V. Phone/Fax

Practice location:
  • Phone: 301-698-8370
  • Fax: 301-698-6072
Mailing address:
  • Phone: 240-676-2755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberD41625
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: