Individual
DOUGLAS JAMES FRASER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5411A BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 256-2474
(703) 941-7938
Mailing address
5411A BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 256-2474
(703) 941-7938
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101023876
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08 00148
UNITED HEALTH CARE
—
01
—
1682
BCBS NATL CAPITAL PROV NO
—
01
—
2146733
MAMSI PROV. NUMBER
—
01
—
244846
NCPPO PROV NUMBER
—
01
—
274557
ANTHEM PROVIDER NUMBER
VA
01
—
698420
FIRST HEALTH PROV NUMBER
—
01
—
78521
AETNA PROVIDER ID NUMBER
—
01
—
ONENET PPO ALLIANCE
2146733
—
Enumeration date
12/07/2006
Last updated
07/09/2007
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