MEDICARE: MR. NJI JULIUS FRU

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	363LF0000X	Family Nurse Practitioner	R203089	MD
2	363LF0000X	Family Nurse Practitioner	RN1028060	DC
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN1028060	DC
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R203089	MD

General Provider Information

NPI Number	:	1275893794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NJI JULIUS FRU

Provider Business Mailing Address
First Line	:	17505 MADRILLON WAY
Second Line	:
City	:	ACCOKEEK
State	:	MD
Zip	:	20607-3457
Country	:	US
Telephone Number	:	301-675-1652
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 CRAIN HWY STE 102
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20603-4841
Country	:	US
Telephone Number	:	301-675-1652
Fax Number	:	240-607-8461

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

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	08/07/2025

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