Provider Demographics
NPI:1245374248
Name:FRAZIER, CHARLES EARL SR (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EARL
Last Name:FRAZIER
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 E NORTHWOOD ST
Mailing Address - Street 2:STE 206
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-274-0168
Mailing Address - Fax:336-274-0340
Practice Address - Street 1:200 E NORTHWOOD ST
Practice Address - Street 2:STE 206
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-274-0168
Practice Address - Fax:336-274-0340
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC018159207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8933698Medicaid
NC8933698Medicaid