Individual
GREGORY FRIEDERICHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 DIVISION ST, WAITE PARK, MN 56387-1331
(320) 253-0365
(320) 253-9401
Mailing address
PO BOX 7654, SAINT CLOUD, MN 56302-7654
(320) 253-0365
(320) 253-9401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2441
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100795
PREFERRED ONE
MN
01
—
146042
MAYO MTG
MN
01
—
2229836
MEDICA
MN
01
—
3C428FR
BLUE CROSS BLUE SHIELD
MN
01
—
U19217
SELECT CARE
MN
Enumeration date
10/10/2005
Last updated
12/04/2007
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