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Individual

JOHN E FREDELL

Active
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Individual

JOHN E FREDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24059
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106058
MEDICA #
MN
01
—
0106061
MEDICA #
MN
01
—
0106863
MEDICA #
MN
01
—
01603FR
MNBS #
MN
01
—
10065
NDBS #
MN
01
—
125910
UCARE #
MN
05
—
18686
—
MN
01
—
900856
AMERICA'S PPO/ARAZ #
MN
01
—
DA9041015692
PREFERRED ONE #
MN
01
—
HP19497
HEALTHPARTNERS #
MN
01
—
MN100038
LHS/BANNERHEALTH #
MN
Enumeration date
06/14/2006
Last updated
02/01/2012
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