Healthcare Provider Details

I. General information

NPI: 1487970596
Provider Name (Legal Business Name): DR. JAMIE LEE FRASER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 08/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW DIVISION OF GENETICS AND METABOLISM
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW DIVISION OF GENETICS AND METABOLISM
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-5000
  • Fax: 202-476-5000
Mailing address:
  • Phone: 202-476-5000
  • Fax: 202-476-5000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberMD040659
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: