MEDICARE: DR. RIDA ANIS FRAYHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	D21058	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750328308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIDA ANIS FRAYHA M.D.

Provider Business Mailing Address
First Line	:	12 FOX KNOLL CT
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-2848
Country	:	US
Telephone Number	:	410-358-2741
Fax Number	:	410-358-5184

Provider Business Practice Location Address
First Line	:	3640 FORDS LN
Second Line	:	SUITE E
City	:	BALTIMORE
State	:	MD
Zip	:	21215-2931
Country	:	US
Telephone Number	:	410-358-2741
Fax Number	:	410-358-5184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	11/13/2009

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