Individual
ROY DEGRANGE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 W 7TH ST, FREDERICK, MD 21701-4506
(250) 566-3300
Mailing address
6215 MARGARITA WAY, FREDERICK, MD 21703-2894
(301) 471-8912
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R204452
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
R204452
MD
Other
Enumeration date
01/27/2020
Last updated
06/09/2020
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