Provider Demographics
NPI:1609862754
Name:FRATTO, CARMEN ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:ANTHONY
Last Name:FRATTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 WESTSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4062
Mailing Address - Country:US
Mailing Address - Phone:410-744-6741
Mailing Address - Fax:410-744-4698
Practice Address - Street 1:407 WESTSIDE BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4062
Practice Address - Country:US
Practice Address - Phone:410-744-6741
Practice Address - Fax:410-744-4698
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0001789207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease