Individual
JEREMY L FRIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
44972
MN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
44972
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245910800
—
MN
Enumeration date
01/24/2006
Last updated
07/21/2022
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