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NPI Code Detail

MEDICARE: DR. STEPHEN ASHLEY FRY M.D.

MEDICARE: DR. STEPHEN ASHLEY FRY 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
1207Q00000XFamily Medicine Physician200000424NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
422827OTHERNCPARTNERS MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21257EOTHERNCBCBS NC
396526OTHERNCMEDCOST
54417505OTHERNCAETNA

General Provider Information

NPI Number : 1659334456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN ASHLEY FRY M.D.
Provider Business Mailing Address
First Line : 1200 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1004
Country : US
Telephone Number : 336-832-7000
Fax Number :
Provider Business Practice Location Address
First Line : 3803 ROBERT PORCHER WAY
Second Line :
City : GREENSBORO
State : NC
Zip : 27410-2191
Country : US
Telephone Number : 336-286-3442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 09/27/2021

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