Healthcare Provider Details

I. General information

NPI: 1255426268
Provider Name (Legal Business Name): ZAHID G FRASER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 ASHLEY CIRCLE PEDIATRIC ASSOCIATES
BOWLING GREEN KY
42104
US

IV. Provider business mailing address

201 PARK ST
BOWLING GREEN KY
42101-1759
US

V. Phone/Fax

Practice location:
  • Phone: 270-782-8700
  • Fax: 270-782-8704
Mailing address:
  • Phone: 270-782-8700
  • Fax: 270-782-8704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number32092
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: