Provider Demographics
NPI:1174519615
Name:SPELLMAN, FRANK ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANTHONY
Last Name:SPELLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7501 GREENWAY CENTER DR # 300
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-474-4679
Mailing Address - Fax:301-474-7182
Practice Address - Street 1:660 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4346
Practice Address - Country:US
Practice Address - Phone:201-331-1188
Practice Address - Fax:202-833-8872
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047384207W00000X
DCMD14019207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC023752700Medicaid
VA1174519615Medicaid
MD377111300Medicaid
MD377111300Medicaid
DC023752700Medicaid