Provider Demographics
NPI:1336776228
Name:FRYE, KRYSTA STEPHANIE (MD)
Entity Type:Individual
Prefix:
First Name:KRYSTA
Middle Name:STEPHANIE
Last Name:FRYE
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 1:5999 BURKE COMMONS RD
Mailing Address - Street 2:ATTN: KRYSTA FRYE MD
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:662-265-9506
Practice Address - Street 1:5999 BURKE COMMONS RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2880
Practice Address - Country:US
Practice Address - Phone:703-249-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101277773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine