Individual
JOHN E FREDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40520 COUNTY HIGHWAY 34, OGEMA, MN 56569-9612
(218) 983-4300
(218) 983-6394
Mailing address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24059
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106058
MEDICA #
MN
01
—
0106061
MEDICA #
MN
01
—
0106863
MEDICA #
MN
01
—
01603FR
MNBS #
MN
01
—
10065
NDBS #
MN
01
—
125910
UCARE #
MN
05
—
18686
—
MN
01
—
900856
AMERICA'S PPO/ARAZ #
MN
01
—
DA9041015692
PREFERRED ONE #
MN
01
—
HP19497
HEALTHPARTNERS #
MN
01
—
MN100038
LHS/BANNERHEALTH #
MN
Enumeration date
06/14/2006
Last updated
02/01/2012
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