Provider Demographics
NPI:1881889277
Name:FRAZIER, HAWWA SHARIF (DO)
Entity type:Individual
Prefix:DR
First Name:HAWWA
Middle Name:SHARIF
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WHITEHEAD AVE
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1187
Mailing Address - Country:US
Mailing Address - Phone:732-638-4688
Mailing Address - Fax:732-360-5081
Practice Address - Street 1:340 EXCHANGE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:GA
Practice Address - Zip Code:30620-1759
Practice Address - Country:US
Practice Address - Phone:678-963-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09310600207Q00000X
GA89615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1881889277Medicaid
NJ316822OtherPTAN
VA1881889277Medicaid