MEDICARE: DR. KRISTINA B 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	207V00000X	Obstetrics & Gynecology Physician	40987	CO

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	:	1952399065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINA B FRASER MD

Provider Business Mailing Address
First Line	:	4900 S MONACO ST
Second Line	:	SUITE 210
City	:	DENVER
State	:	CO
Zip	:	80237-3486
Country	:	US
Telephone Number	:	303-320-8499
Fax Number	:	303-320-8620

Provider Business Practice Location Address
First Line	:	4500 E. 9TH AVE
Second Line	:	SUITE 470
City	:	DENVER
State	:	CO
Zip	:	80220-3923
Country	:	US
Telephone Number	:	303-320-8499
Fax Number	:	303-320-8620

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	04/04/2012

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