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Individual

MICHAEL J FRONDORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6431 FANNIN ST, SUITE MSB 5.196, HOUSTON, TX 77030-5389
(713) 500-6223
Mailing address
14301 ASCHE RD, SUNMAN, IN 47041-7556
(513) 444-6278

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01094136A
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104270374
ANTHEM PTAN
IN
05
300092596
IN
Enumeration date
04/08/2020
Last updated
12/03/2024
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