Individual
ERIC FREDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 MACCORKLE AVE SE STE B-16, CHARLESTON, WV 25304-1227
(304) 388-5848
Mailing address
3845 24TH AVE S, MINNEAPOLIS, MN 55406-3005
(612) 876-5674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29748
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2016
Last updated
08/30/2021
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