Fraser, Richard Mark

Fraser, Richard Mark is an individual health care provider with primary practice located at 8450 Seasons Pkwy Mail 32300A, Woodbury MN 55125-4402. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fraser, Richard Mark can be contacted via phone (651) 702-5300.

Contact Information

Primary practice address
8450 Seasons Pkwy Mail 32300A Woodbury MN 55125-4402
Phone: (651) 702-5300
Fax: (651) 702-5361
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 26386 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 23048 Wisconsin

Profile Details

NPI number 1386616746
LBN Legal business name Fraser, Richard Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Jul 8th, 2007 - about 19 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 1386616746 NPPES
Minnesota MEDICAID 100082900

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