Provider Demographics
NPI:1558710855
Name:PATRICIA C FRYE, MD LLC
Entity Type:Organization
Organization Name:PATRICIA C FRYE, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-328-3045
Mailing Address - Street 1:6930 CARROLL AVE
Mailing Address - Street 2:SUITE 412
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4423
Mailing Address - Country:US
Mailing Address - Phone:301-328-3045
Mailing Address - Fax:844-213-8973
Practice Address - Street 1:6930 CARROLL AVE
Practice Address - Street 2:SUITE 412
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4423
Practice Address - Country:US
Practice Address - Phone:301-328-3045
Practice Address - Fax:844-213-8973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0028622261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1295106078OtherNPI