MEDICARE: MARIE FREDERICK

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	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992411854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE FREDERICK

Provider Business Mailing Address
First Line	:	2113 ALICE AVE APT 101
Second Line	:
City	:	FOREST HEIGHTS
State	:	MD
Zip	:	20745-3511
Country	:	US
Telephone Number	:	240-425-7650
Fax Number	:

Provider Business Practice Location Address
First Line	:	2113 ALICE AVE APT 101
Second Line	:
City	:	FOREST HEIGHTS
State	:	MD
Zip	:	20745-3511
Country	:	US
Telephone Number	:	240-425-7650
Fax Number	:

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

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	01/25/2023

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Directions to “ MARIE FREDERICK ” Practice Location

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