Organization
JARRETT CORPORATION
Active
Other names
Frederick Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INNOCENT MONYA-TAMBI M.D. (ATTENDING PHYSICIAN)
(443) 370-5348
Entity
Organization
Contact information
Practice address
45 WAVERLEY DR, SUITE O, FREDERICK, MD 21702-4854
(301) 624-5999
(301) 624-5997
Mailing address
45 WAVERLEY DR, SUITE O, FREDERICK, MD 21702-4854
(301) 624-5999
(301) 624-5997
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D0076463
MD
Other
Enumeration date
10/29/2015
Last updated
07/15/2016
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