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General NPI Number Information
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NPI Number | 1861443103
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Entity Type | Organization
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Legal Business Name | JOSEPH S. FASTOW, M.D., P.A.
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 HOSPITAL RD
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4017
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Country | US
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Telephone | 301-855-1012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1436
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City | BALTIMORE
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State | MD
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Zip | 21203-1436
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Country | US
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Telephone | 301-652-2707
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Fax | 301-907-4570
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH S FASTOW
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Credential | M.D.
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Telephone | 301-652-2707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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