Healthcare Provider Details

I. General information

NPI: 1699837286
Provider Name (Legal Business Name): GERALD NEIL FRISHMAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 THOMAS JOHNSON DR STE B
FREDERICK MD
21702-5186
US

IV. Provider business mailing address

181 THOMAS JOHNSON DR STE B
FREDERICK MD
21702-5186
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-5474
  • Fax: 301-663-5955
Mailing address:
  • Phone: 301-662-5474
  • Fax: 301-663-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberTA0861
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: