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General NPI Number Information
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NPI Number | 1932331477
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Entity Type | Organization
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Legal Business Name | W FRASER VIPOND M.D.,P.C.
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 20919 GRATIOT AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-774-2626
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Fax | 586-774-2340
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Provider Business Mailing Address
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Address Line | 20919 GRATIOT AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-2825
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Country | US
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Telephone | 586-774-2626
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Fax | 586-774-2340
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. W. FRASER VIPOND
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Credential | M.D.
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Telephone | 586-774-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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