Provider Demographics
NPI:1780602433
Name:FRAZIER, A LINDSAY (MD SCM)
Entity type:Individual
Prefix:
First Name:A
Middle Name:LINDSAY
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MD SCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BINNEY STREET
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6013
Mailing Address - Country:US
Mailing Address - Phone:617-632-2273
Mailing Address - Fax:617-632-4850
Practice Address - Street 1:44 BINNEY STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-2273
Practice Address - Fax:617-632-4850
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA602812080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
060281OtherTUFTS
2937813OtherAETNA
E65266DFOtherHPHC DFCI ONLY
000000029360OtherBMC HEALTHNET
3068862OtherMASSHEALTH MA MEDICAID
J10210OtherBCBS MA IDEMNITY BC ELECT
23292OtherFALLON COMMUNITY HLTH PLA
MA3068862Medicaid
2937813OtherAETNA US HEALTHCARE
7540002OtherUNITED HEALTHCARE
4854472OtherCIGNA
3068862OtherMASSHEALTH MA MEDICAID
E65266Medicare UPIN