Provider Demographics
NPI:1609899640
Name:FRAZIER, ARTHUR J (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:J
Last Name:FRAZIER
Suffix:
Gender:M
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:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-0598
Mailing Address - Country:US
Mailing Address - Phone:586-493-7510
Mailing Address - Fax:586-493-7511
Practice Address - Street 1:1000 HARRINGTON BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2992
Practice Address - Country:US
Practice Address - Phone:586-493-7510
Practice Address - Fax:586-493-7511
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0558572085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4584543Medicaid
MIN88650001Medicare ID - Type Unspecified
MI4584543Medicaid