Provider Demographics
NPI:1710927652
Name:FRAIZ, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FRAIZ
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 1:12302 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5807
Mailing Address - Country:US
Mailing Address - Phone:317-564-4836
Mailing Address - Fax:317-587-2342
Practice Address - Street 1:11455 N MERIDIAN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1624
Practice Address - Country:US
Practice Address - Phone:317-582-8180
Practice Address - Fax:317-582-8185
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032991A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100228490 AMedicaid
IN095700 DMedicare PIN
INC25650Medicare UPIN