Individual
JORDAN A FREIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 3016B, SAINT LOUIS, MO 63141-8232
(314) 251-6339
(314) 251-4564
Mailing address
621 S NEW BALLAS RD, SUITE 3016B, SAINT LOUIS, MO 63141-8232
(314) 251-6339
(314) 251-4564
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
2008005512
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366592925
—
MO
01
—
P00673724
RAILROAD MEDICARE
MO
Enumeration date
01/12/2007
Last updated
07/15/2014
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