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General NPI Number Information
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NPI Number | 1528187317
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Entity Type | Organization
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Legal Business Name | MONOCACY EMERGENCY PHYSICIANS PC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 5930 FREDERICK CROSSING LN
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City | FREDERICK
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State | MD
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Zip | 21704-5137
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Country | US
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Telephone | 240-379-7776
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Fax | 240-378-7787
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Provider Business Mailing Address
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Address Line | 5930 FREDERICK CROSSING LN
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City | FREDERICK
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State | MD
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Zip | 21704-5137
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Country | US
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Telephone | 240-379-7776
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Fax | 240-378-7787
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TRUMER JAMES WAGNER JR.
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Credential | MD
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Telephone | 240-379-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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