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Individual

DR. MICHAEL W FRIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
91 PERIMETER RD, SUITE 110, ROME, NY 13441-4018
(315) 339-7965
Mailing address
PO BOX 669, ROME, NY 13442-0669

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
145677
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02281134
NY
Enumeration date
08/22/2005
Last updated
09/13/2007
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