| Hibiscus Medical Pllc | |
|
430 Galloway St Ne Ste A Washington DC 20011-6312 | |
| (202) 350-1546 | |
| Not Available |
| Full Name | Hibiscus Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 430 Galloway St Ne Ste A, Washington, District Of Columbia |
| Authorized Official Name and Position | Debralee B Frederick (OWNER, PHYSICIAN) |
| Authorized Official Contact | 3472280719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hibiscus Medical Pllc 430 Galloway St Ne Ste A Washington DC 20011-6312 Ph: (202) 350-1546 | Hibiscus Medical Pllc 430 Galloway St Ne Ste A Washington DC 20011-6312 Ph: (202) 350-1546 |
| NPI Number | 1154948362 |
|---|---|
| Provider Enumeration Date | 07/03/2020 |
| Last Update Date | 03/11/2022 |
| Medicare PECOS PAC ID | 2264811348 |
|---|---|
| Medicare Enrollment ID | O20221014002994 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154948362 | NPI | - | NPPES |
| 124113300 | Medicaid | MD | |
| 085010500 | Medicaid | DC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Debralee B Frederick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093034944 PECOS PAC ID: 9335360957 Enrollment ID: I20141024000539 |
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