Individual
REGINA FROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22050 MACK AVE, SAINT CLAIR SHORES, MI 48080-2388
(586) 777-2550
(586) 777-2447
Mailing address
PO BOX 806445, SAINT CLAIR SHORES, MI 48080-6445
(586) 777-2550
(586) 777-2447
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301083979
MI
207VG0400X
Gynecology Physician
4301083979
MI
207VX0000X
Obstetrics Physician
4301083979
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-0502285-2
BCBS INDIVIDUAL PIN
MI
01
—
700E012740
BCBS GROUP NUMBER
MI
Enumeration date
05/25/2007
Last updated
04/18/2011
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