Provider Demographics
NPI:1508904079
Name:FRAED, CYNTHIA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANNE
Last Name:FRAED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HIDDEN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5460
Mailing Address - Country:US
Mailing Address - Phone:919-401-4740
Mailing Address - Fax:
Practice Address - Street 1:121 S ESTES DR
Practice Address - Street 2:SUITE 205-D
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2868
Practice Address - Country:US
Practice Address - Phone:919-969-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-054359207V00000X
MOR6686207V00000X
NC2005-00376207V00000X
OH35.090624207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2914547Medicaid