Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 0101042210 | VA |
NPI | 1033195904 |
---|---|
Provider Name | Dr. Charles R Frakes |
First Address | Sunrise, FL 33345-2409 |
Second Address | Richmond, VA 23229-5205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6735631 | (05) | VA |
E15025 | (02) |