Provider Demographics
NPI:1245299932
Name:DELBOY, FREDERICK WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:DELBOY
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 1:6602 CHURCH HILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-2316
Mailing Address - Country:US
Mailing Address - Phone:410-778-0300
Mailing Address - Fax:410-778-0351
Practice Address - Street 1:6602 CHURCH HILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-2316
Practice Address - Country:US
Practice Address - Phone:410-778-0300
Practice Address - Fax:410-778-0351
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051735207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7BB302100Medicaid
MD7BB302100Medicaid
G61890Medicare UPIN