Provider Demographics
NPI:1922487792
Name:MONOCACY HEALTH PARTNERS LLC
Entity Type:Organization
Organization Name:MONOCACY HEALTH PARTNERS LLC
Other - Org Name:MONOCACY HEALTH PARTNERS INTERNAL MEDICINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO AND SR. VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-566-3355
Mailing Address - Street 1:300 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4541
Mailing Address - Country:US
Mailing Address - Phone:301-662-8119
Mailing Address - Fax:
Practice Address - Street 1:300 W 9TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4541
Practice Address - Country:US
Practice Address - Phone:301-662-8119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONOCACY HEALTH PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty