Provider Demographics
NPI:1174565386
Name:FREY, ANTHONY J (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:FREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5454 ROYAL MILE BLVD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2321
Mailing Address - Country:US
Mailing Address - Phone:410-341-3340
Mailing Address - Fax:410-341-3340
Practice Address - Street 1:1205 PEMBERTON DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2483
Practice Address - Country:US
Practice Address - Phone:410-341-0300
Practice Address - Fax:410-341-0030
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0053394207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
824M 437FMedicare ID - Type Unspecified
G61735Medicare UPIN