Individual
DR. BRADLEY T FRIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
52 TIMBERLANE, SOUTH BURLINGTON, VT 05403-7296
(802) 658-2320
(802) 863-6933
Mailing address
52 TIMBERLANE, SOUTH BURLINGTON, VT 05403-7296
(802) 658-2320
(802) 863-6933
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0420010235
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007927
—
VT
01
—
260145
MVP
VT
01
—
58106
BLUE CROSS BLUE SHEILD
VT
Enumeration date
07/27/2006
Last updated
07/08/2007
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