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General NPI Number Information
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NPI Number | 1235237405
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Entity Type | Individual
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Provider Name | TERESA ELIZABETH FRAZER M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 510 CHERRY ST SUITE #201
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City | BLUEFIELD
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State | WV
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Zip | 24701-3338
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Country | US
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Telephone | 304-327-1630
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Fax | 304-327-1660
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Provider Business Mailing Address
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Address Line | 1320 MAPLEWOOD AVE SUITE #201
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City | RONCEVERTE
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State | WV
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Zip | 24970-8016
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Country | US
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Telephone | 304-647-4411
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Fax | 304-645-1439
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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 | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 19621
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License Number State | WV
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