Provider Demographics
NPI:1538232657
Name:DOZIER, FRED AUGUSTUS (MD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:AUGUSTUS
Last Name:DOZIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 602230
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2230
Mailing Address - Country:US
Mailing Address - Phone:828-894-3300
Mailing Address - Fax:828-899-3377
Practice Address - Street 1:44 HOSPITAL DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-8516
Practice Address - Country:US
Practice Address - Phone:828-894-3300
Practice Address - Fax:828-899-3377
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17446208600000X
NC200701443208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1538232657Medicaid
GA00173533DMedicaid
SCNC1292Medicaid
SCNC1292Medicaid
NC2023198AMedicare PIN
GA00173533DMedicaid