Individual
ANDRE FREDIEU
Active
Individual
ANDRE FREDIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
31365
OK
2084N0400X
Neurology Physician
P5364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001746276
MOUNTAIN STATE BCBS
VA
05
—
010176026
—
VA
01
—
180288
ANTHEM BCBS
VA
05
—
200590450A
—
OK
05
—
3810002589
—
WV
01
—
P00235877
RAILROAD MEDICARE
VA
Enumeration date
01/19/2006
Last updated
08/11/2015
Update your record
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