MEDICARE: DR. TERESE FRAZIER LANDRY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	254545	MA

General Provider Information

NPI Number	:	1437460045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERESE FRAZIER LANDRY M.D.

Provider Business Mailing Address
First Line	:	203 LOWELL ST
Second Line	:
City	:	WILMINGTON
State	:	MA
Zip	:	01887-2980
Country	:	US
Telephone Number	:	978-658-9931
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 LOWELL ST
Second Line	:
City	:	WILMINGTON
State	:	MA
Zip	:	01887-2980
Country	:	US
Telephone Number	:	978-658-9931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	11/07/2025

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