Provider Demographics
NPI:1568470334
Name:FRATANTONI, KAREN RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:RUTH
Last Name:FRATANTONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RUTH
Other - Last Name:BROYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6104 RUDYARD DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2238
Mailing Address - Country:US
Mailing Address - Phone:301-530-7674
Mailing Address - Fax:
Practice Address - Street 1:344 UNIVERSITY BLVD W STE 112
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1969
Practice Address - Country:US
Practice Address - Phone:301-681-6730
Practice Address - Fax:301-681-4268
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00548962080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine