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Individual

MS. MEGHAN FRASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 757-3803
(856) 365-7773
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00192400
NJ
363A00000X
Physician Assistant
MA053058
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
063045
MEDICARE GROUP NUMBER
PA
Enumeration date
06/02/2008
Last updated
07/26/2021
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