Individual
DR. DAVID GORDON FRYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4300 CASCADE RD SE, SUITE 103, GRAND RAPIDS, MI 49546-3631
(616) 243-7900
(616) 243-8299
Mailing address
4300 CASCADE RD SE, SUITE 103, GRAND RAPIDS, MI 49546-3631
(616) 243-7900
(616) 243-8299
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
DF007503
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054106025
BLUE CROSS BLUE SHIELD
MI
05
—
2747523
—
MI
01
—
DF007503
STATE LICENSE NUMBER
MI
Enumeration date
10/17/2005
Last updated
02/26/2008
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