Provider Demographics
NPI:1649337163
Name:FRADKIN, JUDITH ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ELAINE
Last Name:FRADKIN
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 1:6328 LENOX RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6024
Mailing Address - Country:US
Mailing Address - Phone:301-496-7349
Mailing Address - Fax:
Practice Address - Street 1:6100 CENTER DR # 9A27
Practice Address - Street 2:NIDDK, NIH
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-7349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037442207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism