LAKESIDE MED, LLC


Address: 7820b Wormans Mill Rd # 276, Frederick, MD 21701-3034
Phone: 7172203266

LAKESIDE MED, LLC (NPI# 1073142147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073142147
Entity Type Organization
Organization Name LAKESIDE MED, LLC
Practice Address 7820b Wormans Mill Rd # 276
Frederick
MD 21701-3034
Practice Telephone 7172203266
Mailing Telephone 7172203266
Enumeration Date 2020-04-02
Last Update Date 2020-04-02
Authorized Official Name DOUGLAS H BROWN (MEMBER)
Authorized Official Telephone 7172203266
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Mason-Dixon Mobile Medicine Doing Business As Name - Organization

Office Location

Street Address 7820B WORMANS MILL RD # 276
City FREDERICK
State MD
Zip Code 21701-3034

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1225670045 Alana Earp Social Worker 810 Toll House Avenue, Frederick, MD 21701 2019-10-14
1851866065 Main Place Treatment Centers LLC. Clinic/Center 127 S. Smallwood Street, Frederick, MD 21701 2018-10-04
1649775933 Old Fashion Medicine, Inc Internal Medicine 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 2018-03-28
1063917938 Kristin Deely Nurse Practitioner 400 West 7th Street, Cardiac Cath Lab 2nd Floor, Frederick, MD 21701 2018-03-24
1689180119 Harwood Behavioral Health Partners, LLC Community/Behavioral Health 300 B Scholls Lane, Frederick, MD 21701 2017-12-20
1326590068 Natalie Reid Nurse Practitioner 9093 Ridgefield Dr Ste 104, Frederick, MD 21701 2016-10-28
1649727967 Scl Corpration In Home Supportive Care 550 Highland Street, Suite 110, Frederick, MD 21701 2016-09-02
1891159661 Wellave, LLC Clinic/Center 411 Aviation Way Ste 245, Frederick, MD 21701 2016-04-07
1144694969 Leslee Bry Counselor 120 W Church St Ste 3b, Frederick, MD 21701 2015-11-17
1851797732 Frederick Dental Dentist 401 W 7th Street, Frederick Dental, Frederick, MD 21701 2014-11-05
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033754221 Linda A Cann Family Medicine 1738 Wheyfield Dr, Frederick, MD 21701-9337 2019-11-12
1730633785 Skyline Physicians of Md LLC Family Medicine 2110 Walnut Ridge Ct # 1l, Frederick, MD 21702-5921 2016-08-08
1538372826 Jaller Family Medicine, PC Family Medicine 184 Thomas Johnson Dr Ste 200, Frederick, MD 21702-4561 2007-05-07
1083718308 Naaz A Hussain Family Medicine 195 Thomas Johnson Drive, Frederick, MD 21702 2006-09-08
1972606481 Guoping Xu Family Medicine 45 Thomas Johnson Dr Ste 109, Frederick, MD 21702 2006-09-07
1427075324 Comanche County Healthcare Family Medicine 319 E Josephine, Frederick, OK 73542 2006-07-16
1073575015 Praveen K Bolarum Family Medicine 196 Thomas Johnson Dr Ste 135, Frederick, MD 21702 2006-04-05
1447221460 David Elijah Jaller Family Medicine 184 Thomas Johnson Dr, Suite 200, Frederick, MD 21702 2006-01-28
1164492401 Julio J Menocal Family Medicine 110 Baughmans Ln, Suite 140, Frederick, MD 21702-4059 2006-01-26
1407826886 Eugene B Casagrande Family Medicine 1564 Opossumtown Pike, Frederick, MD 21702-4359 2006-01-26
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Competitor

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City FREDERICK
Zip Code 21701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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