Individual
DOUGLAS FRYAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 W HAMLET AVE, HAMLET, NC 28345-4522
(910) 205-8245
(910) 205-8164
Mailing address
1000 W HAMLET AVE, HAMLET, NC 28345-4522
(910) 205-8245
(910) 205-8164
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
030988
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001717376
MTN STATE BCBS
WV
05
—
0065428000
—
WV
05
—
8939420
—
VA
Enumeration date
08/12/2005
Last updated
03/05/2010
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