Healthcare Provider Details

I. General information

NPI: 1346457470
Provider Name (Legal Business Name): JOYCE CHRISTINE FRYE D.O.,M.B.A.,M.S.C.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 KERNAN DR CENTER FOR INTEGRATIVE MEDICINE
BALTIMORE MD
21207-6665
US

IV. Provider business mailing address

29 S PACA ST
BALTIMORE MD
21201-1771
US

V. Phone/Fax

Practice location:
  • Phone: 410-448-6361
  • Fax:
Mailing address:
  • Phone: 410-448-6361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberH0067229
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberOS-005033-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: