Provider Demographics
NPI:1194820928
Name:GRAVINO, FRANK N (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:N
Last Name:GRAVINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8630 FENTON ST STE 1105
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3861
Practice Address - Country:US
Practice Address - Phone:301-681-9095
Practice Address - Fax:410-367-2114
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025080207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
58030003OtherBLUE CROSS DC
CM6438OtherRAILROAD MEDICARE
24324OtherMAMSI
KA62ITOtherBLUE CROSS MD
4086234OtherUNITED HEALTH CARE
MD328461100Medicaid
0787143OtherAETNA
CM6438OtherRAILROAD MEDICARE
4086234OtherUNITED HEALTH CARE