Provider Demographics
NPI:1184738767
Name:FRAUDIN CHIROMED P.C.
Entity type:Organization
Organization Name:FRAUDIN CHIROMED P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRAUDIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:412-257-8090
Mailing Address - Street 1:1030 BOYCE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3907
Mailing Address - Country:US
Mailing Address - Phone:412-257-8090
Mailing Address - Fax:
Practice Address - Street 1:1030 BOYCE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3907
Practice Address - Country:US
Practice Address - Phone:412-257-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2024-03-05
Deactivation Date:2024-02-19
Deactivation Code:
Reactivation Date:2024-03-05
Provider Licenses
StateLicense IDTaxonomies
PADC002566L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000592488OtherBLUE CROSS / BLUE SHIELD