Provider Demographics
NPI:1629332127
Name:FRAZIER, WENDY DEVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:DEVONNE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:636-996-7658
Practice Address - Street 1:1 PROFESSIONAL DR STE 120
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5068
Practice Address - Country:US
Practice Address - Phone:618-463-8555
Practice Address - Fax:618-474-0130
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2024-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE27718207Q00000X
IL036149571207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine