Provider Demographics
NPI:1356485783
Name:FRAYHA, NEDA (MD)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:FRAYHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NEDA
Other - Middle Name:
Other - Last Name:HOMAYOUPOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2850 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3464
Mailing Address - Country:US
Mailing Address - Phone:410-465-8119
Mailing Address - Fax:410-203-2016
Practice Address - Street 1:2850 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3464
Practice Address - Country:US
Practice Address - Phone:410-465-8119
Practice Address - Fax:410-203-2016
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68689207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD332150900Medicaid
MD332150900Medicaid
MDP01122431Medicare PIN