Individual
RENE' D. FREDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 853-0931
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101238586
VA
207R00000X
Internal Medicine Physician
11712
ND
208M00000X
Hospitalist Physician
0101238586
VA
208M00000X
Hospitalist Physician
11712
ND
208M00000X
Hospitalist Physician
51353
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010290813
—
VA
05
—
010290864
—
VA
05
—
010290899
—
VA
Enumeration date
07/15/2006
Last updated
03/30/2023
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