Healthcare Provider Details

I. General information

NPI: 1275502981
Provider Name (Legal Business Name): FADY E TOHME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 CRAYTON BOULEVARD
HAGERSTOWN MD
21742
US

IV. Provider business mailing address

PO BOX 412047
BOSTON MA
02241-2047
US

V. Phone/Fax

Practice location:
  • Phone: 301-791-7900
  • Fax: 301-791-3686
Mailing address:
  • Phone: 301-791-7900
  • Fax: 301-791-3686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD78791
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: