# FREDERICK HEALTH MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FREDERICK HEALTH MEDICAL GROUP LLC
- **Other names:** Frederick Health Medical Group, Monocacy Health Partners LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821366493
- **Legal business name:** FREDERICK HEALTH MEDICAL GROUP LLC
- **Authorized official:** MICHELLE MAHAN (SR. VP AND CFO)
- **Authorized official phone:** (240) 566-3355

## Contact information

- **Practice address:** 194 THOMAS JOHNSON DR, FREDERICK, MD 21702-4679
- **Practice address phone:** (301) 663-3137
- **Practice address fax:** (301) 695-6939
- **Mailing address:** 194 THOMAS JOHNSON DR, FREDERICK, MD 21702-4679
- **Mailing address phone:** (301) 663-3137
- **Mailing address fax:** (301) 695-6939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2011
- **Last updated:** 01/24/2020