Provider Demographics
NPI:1821016528
Name:FRYE, DONALD LEROY (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LEROY
Last Name:FRYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3511 LANSDOWNE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-1366
Mailing Address - Country:US
Mailing Address - Phone:804-323-6675
Mailing Address - Fax:804-323-6675
Practice Address - Street 1:3511 LANSDOWNE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-1366
Practice Address - Country:US
Practice Address - Phone:804-323-6675
Practice Address - Fax:804-323-6675
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0025337208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD66893Medicare ID - Type UnspecifiedNONE