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NPI Code Detail

MEDICARE: MR. CALEB RYAN FRAZIER RD, LDN

MEDICARE: MR. CALEB RYAN FRAZIER RD, LDN
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
1133V00000XRegistered DietitianL006079NC

General Provider Information

NPI Number : 1528332467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CALEB RYAN FRAZIER RD, LDN
Provider Business Mailing Address
First Line : 1301 FAYETTEVILLE ST
Second Line :
City : DURHAM
State : NC
Zip : 27707-2398
Country : US
Telephone Number : 919-956-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1301 FAYETTEVILLE ST
Second Line :
City : DURHAM
State : NC
Zip : 27707-2398
Country : US
Telephone Number : 919-956-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2012
Last Update Date : 11/12/2025

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