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Individual
DORRIE C TREDWAY
Active
Individual
DORRIE C TREDWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036108951
IL
207Q00000X
Family Medicine Physician
2008010712
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156490007
MO PTAN
MO
Enumeration date
08/15/2005
Last updated
12/20/2021
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