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Organization

HIBISCUS MEDICAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEBRALEE B FREDERICK MD (OWNER, PHYSICIAN)
(347) 228-0719
Entity
Organization

Contact information

Practice address
430 GALLOWAY ST NE STE A, WASHINGTON, DC 20011-6312
(202) 350-1546
Mailing address
430 GALLOWAY ST NE STE A, WASHINGTON, DC 20011-6312
(202) 350-1546

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085010500
DC
05
124113300
MD
Enumeration date
07/03/2020
Last updated
03/11/2022
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