Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301088664 | MI |
N | 207VG0400X | Gynecologist | 4301088664 | MI |
NPI | 1184846354 |
---|---|
Provider Name | Dr. Ira Stanley Frye |
First Address | Fenton, MI 48430-4612 |
Second Address | Flint, MI 48532-3456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 28/02/2014 |