MEDICARE: FREDERICK JOSEPH MCDONALD DO

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	H0074428	MD
2	207P00000X	Emergency Medicine Physician	1731	TN

General Provider Information

NPI Number	:	1447237110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK JOSEPH MCDONALD DO

Provider Business Mailing Address
First Line	:	5000 COX RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-9263
Country	:	US
Telephone Number	:	804-968-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 WOODYARD RD
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-4206
Country	:	US
Telephone Number	:	240-546-3428
Fax Number	:

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	08/22/2019

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