Healthcare Provider Details

I. General information

NPI: 1154331577
Provider Name (Legal Business Name): FREDERICK NEONATAL SERVICES SERIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST FMH SPECIAL CARE NURSERY
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

PO BOX 62080
BALTIMORE MD
21264-2080
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3330
  • Fax:
Mailing address:
  • Phone: 866-846-9543
  • Fax: 703-289-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MARILEA K MILLER
Title or Position: DIRECTOR
Credential: M.D.
Phone: 240-566-3330