Provider Demographics
NPI:1093860017
Name:FRAZIER, CYNTHIA N (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:N
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 N HOWE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-3041
Mailing Address - Country:US
Mailing Address - Phone:910-477-6290
Mailing Address - Fax:
Practice Address - Street 1:1125 N HOWE ST
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-3041
Practice Address - Country:US
Practice Address - Phone:910-477-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01135207VG0400X
ARC6264207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D04550Medicare UPIN
AR51783Medicare ID - Type Unspecified