Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | D44284 | MD |
NPI | 1073518312 |
---|---|
Provider Name | Mark Harry Fraiman |
First Address | Baltimore, MD 21239-2905 |
Second Address | Baltimore, MD 21239-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G23004 | (02) | MD |