Provider Demographics
NPI:1376522334
Name:FRAZIER, CAROL B (DPT)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:B
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WEST RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2310
Mailing Address - Country:US
Mailing Address - Phone:410-321-6606
Mailing Address - Fax:410-321-1583
Practice Address - Street 1:22 WEST RD
Practice Address - Street 2:SUITE 302
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2310
Practice Address - Country:US
Practice Address - Phone:410-321-6606
Practice Address - Fax:410-321-1583
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJ231OtherCAREFIRST BLUE CROSS
MDJ231OtherCAREFIRST BLUE CROSS
MDR12446Medicare UPIN