MEDICARE: FREDERICK HEALTH MEDICAL GROUP LLC

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

General Provider Information

NPI Number	:	1255154316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICK HEALTH MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	400 W 7TH ST
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-4506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	194 THOMAS JOHNSON DR
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4679
Country	:	US
Telephone Number	:	240-215-6310
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, PROFESSIONAL FEES REVENUE
Name	:	JENNY FITZPATRICK
Credential	:
Telephone Number	:	240-439-8774

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	03/11/2026

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Directions to “FREDERICK HEALTH MEDICAL GROUP LLC ” Practice Location

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