Healthcare Provider Details

I. General information

NPI: 1366497372
Provider Name (Legal Business Name): APPLE RIDGE FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 FREDERICK RD
THURMONT MD
21788-1809
US

IV. Provider business mailing address

20 FREDERICK RD
THURMONT MD
21788-1809
US

V. Phone/Fax

Practice location:
  • Phone: 301-979-9636
  • Fax: 717-338-9070
Mailing address:
  • Phone: 301-979-9636
  • Fax: 717-338-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TALBOT SMITH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-979-9636