MEDICARE: FRANK MRAZ MD

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	44456	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720033186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK MRAZ MD

Provider Business Mailing Address
First Line	:	PO BOX 396
Second Line	:
City	:	CRANDON
State	:	WI
Zip	:	54520-0396
Country	:	US
Telephone Number	:	715-478-4328
Fax Number	:	715-478-4496

Provider Business Practice Location Address
First Line	:	5409 EVERYBODY'S ROAD
Second Line	:
City	:	CRANDON
State	:	WI
Zip	:	54520
Country	:	US
Telephone Number	:	715-478-4328
Fax Number	:	715-478-4496

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	04/01/2009

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