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General NPI Number Information
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NPI Number | 1386827137
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Entity Type | Organization
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Legal Business Name | DAVID G FRYE PC
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 4300 CASCADE RD SE SUITE 103
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-3631
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Country | US
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Telephone | 616-243-7900
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Fax | 616-243-8299
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Provider Business Mailing Address
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Address Line | 4300 CASCADE RD SE SUITE 103
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-3631
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Country | US
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Telephone | 616-243-7900
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Fax | 616-243-8299
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DAVID GORDON FRYE
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Credential | D.O.
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Telephone | 616-243-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DF007503
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License Number State | MI
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