Fraser, Malcolm R

Fraser, Malcolm R is an individual health care provider with primary practice located at 605 Lamar Ave , Brooksville FL 34601-3211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Fraser, Malcolm R can be contacted via phone (352) 799-5411.

Contact Information

Primary practice address
605 Lamar Ave Brooksville FL 34601-3211
Phone: (352) 799-5411
Fax: (352) 544-2713
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X ME36199 Florida

Profile Details

NPI number 1861486177
LBN Legal business name Fraser, Malcolm R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2005
Last updated Sep 22nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861486177 NPPES
Florida Other 62242 BC/BS FLA
Florida Other 010065834 BC/BS FLA
Florida MEDICAID 039210300 BC/BS FLA
Florida Other 010066083 BC/BS FLA
Florida Other 010066171 BC/BS FLA

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