Provider Demographics
NPI:1568924355
Name:FRASER, HELYN GRISSOM (MD)
Entity Type:Individual
Prefix:
First Name:HELYN
Middle Name:GRISSOM
Last Name:FRASER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HELYN
Other - Middle Name:ELIZABETH
Other - Last Name:GRISSOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:57 EXECUTIVE PARK S RM 160-4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2288
Mailing Address - Country:US
Mailing Address - Phone:404-778-2516
Mailing Address - Fax:404-778-8192
Practice Address - Street 1:57 EXECUTIVE PARK S RM 160-4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2288
Practice Address - Country:US
Practice Address - Phone:404-778-2516
Practice Address - Fax:404-778-8192
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program