Doctor Name: | FRITZ F FRYE |
NPI Number: | 1124137237 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 1076 |
Business Practice Address: | 1413 Highway 17 N Surfside Beach, SC - 295756012 |
Business Phone Number: | 8432385654 |
Business Fax Number: | 8432381624 |
Mailing Address: | 14396 Pee Dee Rd S, GALIVANTS FERRY |
State: | SC |
Postal Code: | 295449056 |
Phone Number: | 8432385654 |
Fax Number: | 8432381624 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1076 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |