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General NPI Number Information
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NPI Number | 1750972659
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Entity Type | Individual
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Provider Name | DOUGLAS FRAZER
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Gender | Male
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 6818 LANKSIDE COURT
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City | CHARLOTTE
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State | NC
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Zip | 28277-0771
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Country | US
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Telephone | 980-417-1551
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Fax |
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Provider Business Mailing Address
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Address Line | 6420 REA RD STE A1
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City | CHARLOTTE
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State | NC
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Zip | 28277-0771
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Country | US
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Telephone | 980-417-1551
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number | HC5797
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HC5797
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HC5797
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License Number State | NC
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