MEDICARE: DENISE M FRASER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	214813	MA
2	2086S0127X	Trauma Surgery Physician	214813	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306844212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE M FRASER MD

Provider Business Mailing Address
First Line	:	ONE HOSPITAL ROAD
Second Line	:	P.O. BOX 1477
City	:	OAK BLUFFS
State	:	MA
Zip	:	02557-1477
Country	:	US
Telephone Number	:	508-693-0410
Fax Number	:	508-693-5971

Provider Business Practice Location Address
First Line	:	ONE HOSPITAL ROAD
Second Line	:
City	:	OAK BLUFFS
State	:	MA
Zip	:	02557-1477
Country	:	US
Telephone Number	:	508-693-0410
Fax Number	:	508-693-5971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	10/27/2014

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Directions to “ DENISE M FRASER MD” Practice Location

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