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General NPI Number Information
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NPI Number | 1851609093
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Entity Type | Organization
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Legal Business Name | DONALD D. FRASER, M.D., P.A.
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 1901 BRUNSWICK AVE SUITE 240
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City | CHARLOTTE
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State | NC
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Zip | 28207-2809
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Country | US
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Telephone | 704-377-3299
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Fax | 704-376-6644
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Provider Business Mailing Address
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Address Line | 1901 BRUNSWICK AVE SUITE 240
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City | CHARLOTTE
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State | NC
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Zip | 28207-2809
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Country | US
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Telephone | 704-377-3299
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Fax | 704-376-6644
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD DOYLE FRASER
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Credential | M.D.
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Telephone | 704-377-3299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 200001959270
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License Number State | NC
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