Individual
DR. MINDY MARIA FRIMODIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 524-2161
(715) 524-8164
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3264
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50520
WI
207Q00000X
Family Medicine Physician
5101016029
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
450030723
MEDICARE PTAN
WI
Enumeration date
02/28/2007
Last updated
03/21/2012
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