Healthcare Provider Details

I. General information

NPI: 1194995324
Provider Name (Legal Business Name): FREDRICK A ISAACS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 INTERNATIONAL DR SUITE 208
SILVER SPRING MD
20906-1550
US

IV. Provider business mailing address

3801 INTERNATIONAL DR SUITE 208
SILVER SPRING MD
20906-1550
US

V. Phone/Fax

Practice location:
  • Phone: 301-598-8500
  • Fax: 301-598-1787
Mailing address:
  • Phone: 301-598-8500
  • Fax: 301-598-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0054918
License Number StateMD

VIII. Authorized Official

Name: DR. FREDRICK ARTHUR ISAACS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-598-8500