Organization
FREDERICK PRIMARY CARE ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT R LILLY (CEO)
(301) 663-6162
Entity
Organization
Contact information
Practice address
610 SOLAREX CT, FREDERICK, MD 21703-8624
(301) 682-5500
Mailing address
610 SOLAREX CT, FREDERICK, MD 21703-8624
(301) 663-6162
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
926580501
—
MD
05
—
926580502
—
MD
05
—
926580503
—
MD
05
—
926580504
—
MD
05
—
926580505
—
MD
05
—
926580506
—
MD
05
—
926580507
—
MD
05
—
926580508
—
MD
05
—
926580509
—
MD
Enumeration date
12/01/2005
Last updated
02/27/2025
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