| Dr A Frazier Llc | |
|
9821 Greenbelt Rd Suite 104 Lanham MD 20706-2265 | |
| (301) 552-1906 | |
| (301) 805-1505 |
| Full Name | Dr A Frazier Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9821 Greenbelt Rd, Lanham, Maryland |
| Authorized Official Name and Position | Acquanetta Laverne Frazier (OWNER) |
| Authorized Official Contact | 3015521801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr A Frazier Llc Po Box 77793 Washington DC 20013-8793 Ph: (301) 805-4586 | Dr A Frazier Llc 9821 Greenbelt Rd Suite 104 Lanham MD 20706-2265 Ph: (301) 552-1906 |
| NPI Number | 1265676357 |
|---|---|
| Provider Enumeration Date | 04/21/2009 |
| Last Update Date | 07/30/2012 |
| Medicare PECOS PAC ID | 3476819095 |
|---|---|
| Medicare Enrollment ID | O20171114002007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265676357 | NPI | - | NPPES |
| 157411600 | Medicaid | MD | |
| 011722500 | Medicaid | DC | |
| F912 | Other | MD | CAREFIRST BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | D0022435 (Maryland) | Primary |
| Provider Name | Acquanetta L Frazier |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043380140 PECOS PAC ID: 3779576632 Enrollment ID: I20040406001136 |
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