Individual
JEFFREY FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 566-3330
Mailing address
PO BOX 730, FREDERICK, MD 21705-0730
(301) 631-9191
(301) 631-1002
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D0031086
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359821701
—
MD
05
—
76267100
—
MD
Enumeration date
06/15/2006
Last updated
06/10/2010
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