Provider Demographics
NPI:1528187317
Name:MONOCACY EMERGENCY PHYSICIANS PC
Entity Type:Organization
Organization Name:MONOCACY EMERGENCY PHYSICIANS PC
Other - Org Name:WINDING CROSS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUMER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:240-379-7776
Mailing Address - Street 1:5930 FREDERICK CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-5137
Mailing Address - Country:US
Mailing Address - Phone:240-379-7776
Mailing Address - Fax:240-378-7787
Practice Address - Street 1:5930 FREDERICK CROSSING LN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5137
Practice Address - Country:US
Practice Address - Phone:240-379-7776
Practice Address - Fax:240-378-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
5001260001Medicare PIN
MD337MMedicare ID - Type Unspecified