Healthcare Provider Details

I. General information

NPI: 1134119688
Provider Name (Legal Business Name): EMERGENCY PHYSICIAN ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W SEVENTH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

PO BOX 730
FREDERICK MD
21705-0730
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3330
  • Fax:
Mailing address:
  • Phone: 301-631-9191
  • Fax: 301-631-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID FRAZIER
Title or Position: PRESIDENT
Credential: MD
Phone: 301-662-2480