Individual
DR. MARK ROBERT FRACASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2333 ONTARIO RD NW, WASHINGTON, DC 20009-2627
(202) 420-7008
(202) 332-0541
Mailing address
2333 ONTARIO RD NW, WASHINGTON, DC 20009
(202) 420-7008
(202) 332-0541
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101034665
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
D68386
MD
207V00000X
Obstetrics & Gynecology Physician
MD15297
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101034665
MEDICAL LISCENSE
VA
05
—
052748300
—
DC
01
—
581135ZEMB
MEDICARE GROUP MEMEBER PTAN
DC
01
—
G012363
MEDICARE PTAN
DC
Enumeration date
01/18/2007
Last updated
03/07/2023
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