Provider Demographics
NPI:1487093670
Name:FAMILY CARE OF FREDERICKSBURG, PLC
Entity type:Organization
Organization Name:FAMILY CARE OF FREDERICKSBURG, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MULDOON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-840-9815
Mailing Address - Street 1:2216 PRINCESS ANNE ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3300
Mailing Address - Country:US
Mailing Address - Phone:540-840-9815
Mailing Address - Fax:540-371-3748
Practice Address - Street 1:2216 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3300
Practice Address - Country:US
Practice Address - Phone:540-840-9815
Practice Address - Fax:540-371-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty