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NPI Code Detail

MEDICARE: FREDERICK PRIMARY CARE ASSOCIATES, P.A.

MEDICARE: FREDERICK PRIMARY CARE ASSOCIATES, P.A.
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
1133V00000XRegistered Dietitian
2207RE0101XEndocrinology, Diabetes & Metabolism Physician
3207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689658890
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREDERICK PRIMARY CARE ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 610 SOLAREX CT
Second Line :
City : FREDERICK
State : MD
Zip : 21703-8624
Country : US
Telephone Number : 301-663-6162
Fax Number :
Provider Business Practice Location Address
First Line : 610 SOLAREX CT
Second Line :
City : FREDERICK
State : MD
Zip : 21703-8624
Country : US
Telephone Number : 301-682-5500
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. SCOTT R LILLY
Credential :
Telephone Number : 301-663-6162
Provider Enumeration Date : 12/01/2005
Last Update Date : 02/27/2025

Similar Medicare Providers

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Practice Location Address:
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1326047630 — ROSE M WIENHOFF CRNP
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1063496107 — STEPHEN HERNG-SHIU LEE M.D.
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1710961768 — JILL A DURFEE M.D.
Practice Location Address:
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21703-8624
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1104805985 — MRS. VIRGINIA MARIE STANDFORD MSPT
Practice Location Address:
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21703-8624
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