Healthcare Provider Details

I. General information

NPI: 1346270337
Provider Name (Legal Business Name): DANIEL KENNETH FRAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE RADIATION ONCOLOGY, FAHC
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-3506
  • Fax: 802-847-2386
Mailing address:
  • Phone: 800-866-6663
  • Fax: 413-589-0195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number042-0011577
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: