Organization
FRONTIER MEDICAL PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL SURDAM MD (CHIEF MEDICAL OFFICER)
(307) 773-8133
Entity
Organization
Contact information
Practice address
433 E 19TH ST, CHEYENNE, WY 82001-4643
(307) 773-8133
Mailing address
PO BOX 426, CHEYENNE, WY 82003-0426
(307) 426-4676
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
7206A
WY
Other
Enumeration date
04/15/2012
Last updated
06/25/2012
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