Individual
STEPHEN DALE FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3716
(319) 233-1630
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 235-3716
(319) 233-1630
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
32977
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0193102
—
IA
01
—
421417307D4
JOHN DEERE HEALTH INS P
IA
01
—
49304
WELLMARK INS PLAN
IA
Enumeration date
05/19/2006
Last updated
09/06/2007
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