Provider Demographics
NPI:1679738504
Name:FRY, ROBERT WE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WE
Last Name:FRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1111 LAS TABLAS RD STE R
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9732
Mailing Address - Country:US
Mailing Address - Phone:805-434-4848
Mailing Address - Fax:
Practice Address - Street 1:1111 LAS TABLAS RD STE R
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9732
Practice Address - Country:US
Practice Address - Phone:805-434-4848
Practice Address - Fax:855-902-6131
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115889207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery