Individual
DR. TODD FRAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4402 E STATE BLVD, FORT WAYNE, IN 46815-6917
(260) 425-5500
(260) 425-5505
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
01077873A
IN
208D00000X
General Practice Physician
0101251011
VA
208D00000X
General Practice Physician
81697
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
816978
—
SC
Enumeration date
08/06/2008
Last updated
10/15/2022
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