Provider Demographics
NPI:1720053069
Name:HEPFER, FRANKLIN R (PA)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:R
Last Name:HEPFER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BESTGATE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3371
Mailing Address - Country:US
Mailing Address - Phone:102-662-7204
Mailing Address - Fax:410-224-0209
Practice Address - Street 1:1000 BESTGATE RD STE 400
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3371
Practice Address - Country:US
Practice Address - Phone:410-266-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002322363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
487760200OtherFEDERAL WORKMANS COMP
297200OtherAMERIGROUP
018551M21Medicare PIN
577MN834Medicare PIN
P00422945Medicare PIN
487760200OtherFEDERAL WORKMANS COMP