Provider Demographics
NPI:1932753589
Name:FRYER, ROBERT PAUL
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:FRYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 WASHINGTON AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4530
Mailing Address - Country:US
Mailing Address - Phone:410-296-6855
Mailing Address - Fax:410-321-9548
Practice Address - Street 1:502 WASHINGTON AVE STE 270
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4530
Practice Address - Country:US
Practice Address - Phone:410-296-6855
Practice Address - Fax:410-321-9548
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHCS0112008251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care