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General NPI Number Information
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NPI Number | 1922132281
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Entity Type | Organization
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Legal Business Name | FREDERICK ENT GROUP P.A.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 82 THOMAS JOHNSON CT.
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City | FREDERICK
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State | MD
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Zip | 21702-4348
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Country | US
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Telephone | 301-698-2440
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Fax | 301-846-0892
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Provider Business Mailing Address
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Address Line | 82 THOMAS JOHNSON CT.
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City | FREDERICK
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State | MD
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Zip | 21702-4348
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Country | US
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Telephone | 301-698-2440
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Fax | 301-846-0892
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONG YOON
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Credential | M.D.
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Telephone | 301-698-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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