MEDICARE: DR. ALFRED R FRYE DO

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	207Q00000X	Family Medicine Physician	246	SC

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	:	1518928837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFRED R FRYE DO

Provider Business Mailing Address
First Line	:	1818 HENDERSON ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2619
Country	:	US
Telephone Number	:	803-782-4278
Fax Number	:	803-253-8896

Provider Business Practice Location Address
First Line	:	511 BELTLINE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-3627
Country	:	US
Telephone Number	:	803-782-4051
Fax Number	:	803-790-6612

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	01/30/2013

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