Healthcare Provider Details

I. General information

NPI: 1295051621
Provider Name (Legal Business Name): GHISLAINE FOUGY MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10230 NEW HAMPSHIRE AVE SUITE 202
SILVER SPRING MD
20903-1400
US

IV. Provider business mailing address

10230 NEW HAMPSHIRE AVE SUITE 202
SILVER SPRING MD
20903-1400
US

V. Phone/Fax

Practice location:
  • Phone: 301-431-2500
  • Fax: 301-439-5927
Mailing address:
  • Phone: 301-431-2500
  • Fax: 301-439-5927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0018251
License Number StateMD

VIII. Authorized Official

Name: GHISLAINE FOUGY
Title or Position: PROVIDER
Credential: MD
Phone: 410-717-6331