Individual
MARY FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2855 N KEYSTONE AVE, SUITE 100, INDIANAPOLIS, IN 46218-2789
(317) 920-5760
(317) 920-5768
Mailing address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 788-9769
(317) 781-4868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01059801A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200510350
—
IN
Enumeration date
10/20/2005
Last updated
09/08/2011
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