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General NPI Number Information
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NPI Number | 1366601783
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Entity Type | Individual
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Provider Name | MEGHAN FRASER PA
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Gender | Female
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 1600 HADDON AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-3101
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Country | US
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Telephone | 856-757-3803
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Fax | 856-365-7773
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA053058
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00192400
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License Number State | NJ
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