NPI Code Details Logo

NPI 1588284145

NPI 1588284145 : BRETT MICHAEL FRAZIER DO : CAMP LEJEUNE, NC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1588284145
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    BRETT MICHAEL FRAZIER DO
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/23/2020
-----------------------------------------------------
    Last Update Date     |    09/03/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    NAVAL MEDICAL CENTER CAMP LEJEUNE 100 BREWSTER BOULEVARD
-----------------------------------------------------
    City                 |    CAMP LEJEUNE
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28547
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    910-450-3138
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    213 SILVER CREEK LOOP 
-----------------------------------------------------
    City                 |    SNEADS FERRY
-----------------------------------------------------
    State                |    NC
-----------------------------------------------------
    Zip                  |    28460-9490
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    443-553-3298
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    0102206818
-----------------------------------------------------
    License Number State |    VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    171000000X
-----------------------------------------------------
    Taxonomy Name        |    Military Health Care Provider
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.