Provider Demographics
NPI:1083633317
Name:FRIZNER, BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:FRIZNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STABLEMERE CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1063
Mailing Address - Country:US
Mailing Address - Phone:410-404-6092
Mailing Address - Fax:
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:717-339-2025
Practice Address - Fax:717-339-2011
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061886207R00000X
PAMD435609208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108437OtherJOHNS HOPKINS
MD643212OtherCAREFIRST MD BCBS
PA123844OtherGEISINGER HEALTH PLAN
MD406437201Medicaid
PA2080910OtherHIGHMARK BLUE SHIELD
PA102243996Medicaid
MD406437201Medicaid
PA102243996Medicaid
PA140648Medicare PIN
PAP00782105Medicare PIN