FREDERICK CARDIOVASCULAR CARE PC (NPI# 1205827664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205827664 |
| Entity Type | Organization |
| Organization Name | FREDERICK CARDIOVASCULAR CARE PC |
| Practice Address |
97 Thomas Johnson Dr Ste 100 Frederick MD 21702-4379 |
| Practice Telephone | 3016823370 |
| Practice Fax Number | 3016823377 |
| Mailing Telephone | 3016823370 |
| Mailing Fax Number | 3016823377 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID MERRILL SUMMERS (PRESIDENT) |
| Authorized Official Telephone | 3016823370 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
H0039804 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BCBS | 0F53FR | 01 |
| AETNA NON HMO | 4126583 | 01 | |
| DC | BCBS | G4370001 | 01 |
| AETNA HMO | 3001500 | 01 | |
| MAMSI | 42222 | 01 |
| Street Address |
97 THOMAS JOHNSON DR STE 100 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083802656 | Trevia Hayden, Md LLC. | Psychiatry & Neurology | 97 Thomas Johnson Dr, Suite 102, Frederick, MD 21702-4379 | 2007-10-09 |
| 1871781435 | Bert Williams M.d. LLC | Urology | 97 Thomas Johnson Dr, Suite 102, Frederick, MD 21702-4379 | 2007-10-09 |
| 1821131939 | Dawn R Mossburg | Nurse Practitioner | 97 Thomas Johnson Dr, Suite 101, Frederick, MD 21702-4373 | 2007-02-15 |
| 1588685465 | Frederick Psychology Center LLC | Clinic/Center | 97 Thomas Johnson Dr, Suite 202, Frederick, MD 21702-4373 | 2006-07-23 |
| 1154393270 | Kevin Richard Lawlor | Psychologist | 97 Thomas Johnson Dr, Suite 202, Frederick, MD 21702 | 2006-02-02 |
| 1235101361 | Timothy Allen Gibian | Psychologist | 97 Thomas Johnson Dr, Suite 202, Frederick, MD 21702 | 2006-02-02 |
| 1598737629 | Gregory Harry Powell | Psychologist | 97 Thomas Johnson Dr, Ste 202, Frederick, MD 21702 | 2006-02-02 |
| 1164494282 | Cynthia Sue Eaves | Psychologist | 97 Thomas Johnson Dr, Ste 202, Frederick, MD 21702 | 2006-02-02 |
| 1144202995 | Edwin T. Chen | Obstetrics & Gynecology | 97 Thomas Johnson Dr, Suite 101, Frederick, MD 21702-4373 | 2005-11-17 |
| 1932181781 | Debra Acerenza | Obstetrics & Gynecology | 97 Thomas Johnson Dr, Suite 101, Frederick, MD 21702-4373 | 2005-11-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407948771 | Anwar K. Malik | Internal Medicine | 180 Thomas Johnson Drive, Suite 202, Frederick, MD 21702-4550 | 2006-09-28 |
| 1144200619 | Hitesh V Patel | Internal Medicine | 74 Thomas Johnson Drive, Frederick, MD 21702-4501 | 2006-01-19 |
| 1538146451 | David Merrill Summers | Internal Medicine | 97 Thomas Johnson Drive, Suite 100, Frederick, MD 21702-4379 | 2005-12-30 |
| 1952306730 | Kusay Barakat | Internal Medicine | Cardiology Center, 310 West Ninth Street, Frederick, MD 21701-4546 | 2005-06-17 |
| 1043215825 | Jeffrey Nathan Cowen | Internal Medicine | 915 Toll House Ave, Suite 308, Frederick, MD 21701-5930 | 2005-06-17 |
| 1104829605 | Shawn Adrian Buki | Internal Medicine | 310 W 9th St, Frederick, MD 21701-4546 | 2005-05-27 |
| 1932102654 | Edward P Riuli | Internal Medicine | 180 Thomas Johnson Dr, Ste 202, Frederick, MD 21702-4552 | 2005-05-27 |
| 1386934321 | Sana Shaheen Shah | Internal Medicine | 310 W 9th St, Frederick, MD 21701-4546 | 2011-04-11 |
| 1730340449 | Bhavin Mahesh Patel | Internal Medicine | 180 Thomas Johnson Dr, Suite 202, Frederick, MD 21702-4409 | 2008-06-24 |
| 1861650111 | Sara Mekonnen Mekuria | Internal Medicine | 180 Thomas Johnson Drive, Suite 202, Frederick, MD 21702-4550 | 2008-05-22 |
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| 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.