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Individual

DR. MARY FREITAG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD, LP

Contact information

Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 2312 SOUTH 6TH STREET, SUITE F256 / 2B WEST, MINNEAPOLIS, MN 55454
(612) 273-8700
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 2312 SOUTH 6TH STREET, SUITE F256 / 2B WEST, MINNEAPOLIS, MN 55454
(612) 273-9800

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4319
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0492456
MT
01
1028022
PREFERRED ONE
MN
01
130952
UCARE
MN
01
1382591
ARAZ
MN
01
61-57516
MEDICA CHOICE & PRIMARY
MN
01
74G37FR
BCBS
MN
01
HP33776
HEALTHPARTNERS
MN
Enumeration date
07/06/2006
Last updated
07/09/2007
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