Provider Demographics
NPI:1275631301
Name:KNOWLES, FREDERICK EDWIN III (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:EDWIN
Last Name:KNOWLES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 CHESAPEAKE DR.
Mailing Address - Street 2:VA CLINIC
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-9408
Mailing Address - Country:US
Mailing Address - Phone:410-901-4011
Mailing Address - Fax:410-901-4070
Practice Address - Street 1:830 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-9408
Practice Address - Country:US
Practice Address - Phone:410-901-4011
Practice Address - Fax:410-901-4070
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0009054174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist