Provider Demographics
NPI:1992774517
Name:SBROCCO, FRANK ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:ANTHONY
Last Name:SBROCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HOSPITAL RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4019
Mailing Address - Country:US
Mailing Address - Phone:410-535-3787
Mailing Address - Fax:410-257-3866
Practice Address - Street 1:110 HOSPITAL RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4019
Practice Address - Country:US
Practice Address - Phone:410-535-3787
Practice Address - Fax:410-257-3866
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047262207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD219331100Medicaid
MD61564403OtherBLUE SHIELD
0002OtherBLUE SHIELD NCA
I00877Medicare UPIN
352FMedicare PIN