Provider Demographics
NPI:1477556173
Name:GUCKES, FREDERICK H (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:H
Last Name:GUCKES
Suffix:
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:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:410-573-9530
Mailing Address - Fax:410-573-9569
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:STE 304
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3745
Practice Address - Country:US
Practice Address - Phone:410-573-9530
Practice Address - Fax:410-573-9569
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052857207VC0200X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD324562401Medicaid
MD169821Y5ZOtherMEDICARE
MDCY310003OtherBCBS
MD169821ZDWSOtherMEDICARE
MDCY310003OtherBCBS
MDG58552Medicare UPIN