Provider Demographics
NPI:1487904942
Name:FRAZER, CHRISTOPHER MICHAEL (PHARMD, BCACP)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:FRAZER
Suffix:
Gender:M
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MAPLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4726
Mailing Address - Country:US
Mailing Address - Phone:218-310-6217
Mailing Address - Fax:
Practice Address - Street 1:3500 TOWER AVE STE A
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-4685
Practice Address - Country:US
Practice Address - Phone:715-817-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16780-401835P0018X, 1835P2201X
MI53020424691835P2201X
MN1267561835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist