Provider Demographics
NPI:1013533280
Name:FRASER, WILLIAM JOHN DONOHUE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOHN DONOHUE
Last Name:FRASER
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 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EMERGENCY MEDICINE
Practice Address - Street 2:14 MEDICAL PARK, STE 350
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-3790
Practice Address - Fax:803-434-3946
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL84480207P00000X
CODR.0071169207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine