Individual
EDMUNDO ALEJANDRO RODRIGUEZ-FRIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6812 STATE ROUTE 162, SUITE 204, MARYVILLE, IL 62062
(618) 391-5070
(618) 288-1872
Mailing address
6810 STATE ROUTE 162, MARYVILLE, IL 62062
(618) 462-3200
(618) 463-5003
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036-120237
IL
207RG0100X
Gastroenterology Physician
45630
KY
208M00000X
Hospitalist Physician
036.120237
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0022674
INSTITUTIONAL PERMIT
—
Enumeration date
05/22/2007
Last updated
07/19/2024
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