MEDICARE: DR. MICHELLE ANTOINETTE FOLSOM ELDER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0067487	MD

General Provider Information

NPI Number	:	1043433816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE ANTOINETTE FOLSOM ELDER M.D.

Provider Business Mailing Address
First Line	:	110 HOSPITAL RD STE 111
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-4039
Country	:	US
Telephone Number	:	410-535-4488
Fax Number	:	443-771-8114

Provider Business Practice Location Address
First Line	:	110 HOSPITAL RD STE 111
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-4039
Country	:	US
Telephone Number	:	410-535-4488
Fax Number	:	443-771-8114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	01/16/2024

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