Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D0054042 | MD |
NPI | 1013933563 |
---|---|
Provider Name | Fateh Hraky SR. |
First Address | Baltimore, MD 21225-1233 |
Second Address | Baltimore, MD 21225-1233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F09740 | (02) | MD |