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General NPI Number Information
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NPI Number | 1295532190
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Entity Type | Organization
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Legal Business Name | FREDERICK PRIMARY CARE ASSOCIATES, P.A.
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 10260 SILVERSIDE ST STE 100
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City | IJAMSVILLE
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State | MD
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Zip | 21754-9174
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Country | US
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Telephone | 301-682-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 610 SOLAREX CT
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City | FREDERICK
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State | MD
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Zip | 21703-8624
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SCOTT R LILLY
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Credential |
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Telephone | 301-663-6162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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