Individual
BRIAN J FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PATHOLOGY ASSISTANT
Contact information
Practice address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 333-1720
(605) 333-1966
Mailing address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 333-1720
(605) 333-1966
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
0058
SD
363A00000X
Physician Assistant
Primary
0058
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0058
PHYSICIAN ASSISTANT CERTI
SD
Enumeration date
08/17/2007
Last updated
08/17/2007
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