Provider Demographics
NPI:1891892246
Name:EISENBERG, FRANK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:EISENBERG
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 1:2225 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5719
Mailing Address - Country:US
Mailing Address - Phone:410-366-4360
Mailing Address - Fax:410-243-7948
Practice Address - Street 1:2225 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5719
Practice Address - Country:US
Practice Address - Phone:410-366-4360
Practice Address - Fax:410-243-7948
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00229702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD266781900Medicaid
MDH662Z653Medicare UPIN