Individual
DR. MARK DOUGLAS FREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6119 US HIGHWAY 11, CANTON, NY 13617-3991
(315) 261-5850
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 265-3300
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
21783
NE
207Y00000X
Otolaryngology Physician
Primary
330710
NY
207YP0228X
Pediatric Otolaryngology Physician
330710
NY
Other
Enumeration date
03/03/2006
Last updated
09/12/2024
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