Basic Information
| Provider Information | |||||||||
| NPI: | 1720053069 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEPFER | ||||||||
| FirstName: | FRANKLIN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 BESTGATE RD STE 400 | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1026627204 | ||||||||
| FaxNumber: | 4102240209 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 BESTGATE RD STE 400 | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102662720 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2006 | ||||||||
| LastUpdateDate: | 11/26/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | C0002322 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 487760200 | 01 | FEDERAL WORKMANS COMP | OTHER | 297200 | 01 | AMERIGROUP | OTHER |