Provider Demographics
NPI:1073504916
Name:FRAZER, DANA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:FRAZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1299 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3135
Mailing Address - Country:US
Mailing Address - Phone:614-566-4278
Mailing Address - Fax:614-566-5424
Practice Address - Street 1:285 E STATE ST
Practice Address - Street 2:SUITE 620
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4354
Practice Address - Country:US
Practice Address - Phone:614-469-7621
Practice Address - Fax:614-469-8049
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-073390208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2240944Medicaid
OHH35789Medicare UPIN
OHFR4048576Medicare PIN