Provider Demographics
NPI:1407829732
Name:COURT ENDOSCOPY CENTER OF FREDERICK, INC.
Entity type:Organization
Organization Name:COURT ENDOSCOPY CENTER OF FREDERICK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:RIFKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-668-1600
Mailing Address - Street 1:85 THOMAS JOHNSON CT
Mailing Address - Street 2:SUITE E
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4331
Mailing Address - Country:US
Mailing Address - Phone:301-668-1600
Mailing Address - Fax:301-668-4008
Practice Address - Street 1:85 THOMAS JOHNSON CT
Practice Address - Street 2:SUITE E
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4331
Practice Address - Country:US
Practice Address - Phone:301-668-1600
Practice Address - Fax:301-668-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1398261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD170ZMedicare ID - Type Unspecified