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Individual

DR. KEITH EVAN FRASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
134 EVERGREEN PL, 3RD FLOOR, EAST ORANGE, NJ 07018-2011
(973) 678-8144
(973) 678-2830
Mailing address
134 EVERGREEN PL, 3RD FLOOR, EAST ORANGE, NJ 07018-2011
(973) 678-8144
(973) 678-2830

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
53154
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0383367000
AMERIHEALTH
NJ
01
0980497
CIGNA
NJ
01
0K7327
HEALTHNET
NJ
01
1018005
HORIZON NJ HEALTH
NJ
05
3417301
NJ
01
44430
AETNA
NJ
01
P1278567
OXFORD
NJ
Enumeration date
06/28/2006
Last updated
07/08/2007
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