Provider Demographics
NPI:1851609093
Name:DONALD D. FRASER, M.D., P.A.
Entity Type:Organization
Organization Name:DONALD D. FRASER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:DOYLE
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-377-3299
Mailing Address - Street 1:1901 BRUNSWICK AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2809
Mailing Address - Country:US
Mailing Address - Phone:704-377-3299
Mailing Address - Fax:704-376-6644
Practice Address - Street 1:1901 BRUNSWICK AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2809
Practice Address - Country:US
Practice Address - Phone:704-377-3299
Practice Address - Fax:704-376-6644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001959270261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty