Provider Demographics
NPI:1912902800
Name:RICHARDS, FRASER (MD)
Entity Type:Individual
Prefix:DR
First Name:FRASER
Middle Name:
Last Name:RICHARDS
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 1:2202 N FORBES BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1412
Mailing Address - Country:US
Mailing Address - Phone:520-886-3432
Mailing Address - Fax:520-886-0169
Practice Address - Street 1:6567 E CARONDELET DR
Practice Address - Street 2:STE 225
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6152
Practice Address - Country:US
Practice Address - Phone:520-886-3432
Practice Address - Fax:520-886-0169
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37745174400000X, 207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00958349OtherRR MEDICARE
AZ286043Medicaid
AZ37745OtherSTATE LICENSE
ARN8395OtherSTATE LICENSE
BR1890652OtherDEA NUMBER
E76076Medicare UPIN
AZ144895Medicare PIN
AZ115613Medicare PIN