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General NPI Number Information
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NPI Number | 1184846354
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Entity Type | Individual
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Provider Name | IRA STANLEY FRYE MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 818 W KING ST STE LL
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City | OWOSSO
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State | MI
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Zip | 48867-2116
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Country | US
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Telephone | 989-729-4292
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Fax | 989-725-9012
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Provider Business Mailing Address
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Address Line | 818 W KING ST STE LL
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City | OWOSSO
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State | MI
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Zip | 48867-2116
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Country | US
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Telephone | 989-729-4292
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Fax | 989-725-9012
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 4301088664
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301088664
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License Number State | MI
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