Provider Demographics
NPI:1700885530
Name:WESTPHAL, FRAUKE (MD)
Entity Type:Individual
Prefix:DR
First Name:FRAUKE
Middle Name:
Last Name:WESTPHAL
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:PO BOX 791372
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1372
Mailing Address - Country:US
Mailing Address - Phone:301-608-8375
Mailing Address - Fax:301-608-3979
Practice Address - Street 1:1201 SEVEN LOCKS RD
Practice Address - Street 2:SUITE #202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2931
Practice Address - Country:US
Practice Address - Phone:240-314-7080
Practice Address - Fax:240-314-7082
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD200181100Medicaid
MD415096100Medicaid
MD200181100Medicaid
MD415096100Medicaid