Individual
DR. BRADLEY ROBERT FREIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1201 N RUTHERFORD ST, MACON, MO 63552-2020
(660) 385-8900
(660) 385-8708
Mailing address
1201 N RUTHERFORD ST, MACON, MO 63552-2020
(660) 385-8900
(660) 385-8708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
324
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07035
BLUE CROSS PROVIDER #
NE
01
—
200652429
UNITED HEALTHCARE
NE
05
—
200652429
—
NE
01
—
20065242968066
TRICARE PROVIDER
NE
01
—
235966
MIDLANDS CHOICE
NE
01
—
P00128031
RAILROAD MEDICARE
MT
Enumeration date
03/29/2007
Last updated
01/10/2013
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