Provider Demographics
NPI:1730151374
Name:FRIER, CAROLE A (DO)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:A
Last Name:FRIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 WALNUT ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-3401
Mailing Address - Country:US
Mailing Address - Phone:515-243-1180
Mailing Address - Fax:515-243-1461
Practice Address - Street 1:1300 WALNUT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3401
Practice Address - Country:US
Practice Address - Phone:515-243-1180
Practice Address - Fax:515-243-1461
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
390002099OtherRAILROAD MEDICARE
IA0476184Medicaid
09114Medicare ID - Type Unspecified
E46373Medicare UPIN