Organization
FREDERICK FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INNOCENT MONYA-TAMBI MD (OWNER)
(301) 624-5999
Entity
Organization
Contact information
Practice address
1709 ROSEMONT AVE, FREDERICK, MD 21702-4135
(301) 624-5999
(301) 624-5997
Mailing address
1709 ROSEMONT AVE, FREDERICK, MD 21702-4135
(301) 624-5999
(301) 625-5997
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0076463
MD
Other
Enumeration date
04/17/2018
Last updated
04/07/2022
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