Organization
INTERNAL MEDICINE SPECIALIST, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FRYE MD (TREASURER)
(704) 376-7362
Entity
Organization
Contact information
Practice address
3101 LATROBE DR, CHARLOTTE, NC 28211-4849
(704) 376-7362
Mailing address
3101 LATROBE DR, CHARLOTTE, NC 28211-4849
(704) 376-7362
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901076
—
NC
05
—
89013WJ
—
NC
05
—
89013WK
—
NC
05
—
NPB152
—
SC
05
—
NPB153
—
SC
05
—
NPB154
—
SC
Enumeration date
07/05/2006
Last updated
01/15/2008
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