Healthcare Provider Details

I. General information

NPI: 1083190516
Provider Name (Legal Business Name): MD PACS 2 PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NORTH PL
FREDERICK MD
21701-6200
US

IV. Provider business mailing address

265 BROOKVIEW CENTRE WAY STE 400
KNOXVILLE TN
37919-4052
US

V. Phone/Fax

Practice location:
  • Phone: 301-695-6618
  • Fax:
Mailing address:
  • Phone: 865-693-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ISTVAN
Title or Position: PRESIDENT
Credential: MD
Phone: 865-693-1000