Provider Demographics
NPI:1902192156
Name:FRISKE, CASEY ROBERT (DPM)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:ROBERT
Last Name:FRISKE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64134
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4134
Mailing Address - Country:US
Mailing Address - Phone:667-214-2714
Mailing Address - Fax:410-448-6926
Practice Address - Street 1:226 SCHILLING CIR STE 170
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-8641
Practice Address - Country:US
Practice Address - Phone:410-449-6400
Practice Address - Fax:410-785-4840
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01532213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD235307500Medicaid
MD314534YFCHMedicare PIN