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NPI Code Detail

MEDICARE: DR. DENISE JEAN FREIDEL D.O.

MEDICARE:  DR. DENISE JEAN FREIDEL  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician264NE
2207Q00000XFamily Medicine Physician2009034588MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00226181OTHERNERAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200652429OTHERNEUNITED HEALTHCARE
207034OTHERNEBLUE CROSS PROVIDER #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
520065242968066OTHERNETRICARE PROVIDER #
6235965OTHERNEMIDLANDS CHOICE PROVIDER

General Provider Information

NPI Number : 1154441822
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENISE JEAN FREIDEL D.O.
Provider Business Mailing Address
First Line : 300 N MORLEY ST STE A
Second Line :
City : MOBERLY
State : MO
Zip : 65270-2334
Country : US
Telephone Number : 660-263-1225
Fax Number : 660-263-1255
Provider Business Practice Location Address
First Line : 300 N MORLEY ST STE A
Second Line :
City : MOBERLY
State : MO
Zip : 65270-2334
Country : US
Telephone Number : 660-263-1225
Fax Number : 660-263-1255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 12/01/2022

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Directions to “ DR. DENISE JEAN FREIDEL D.O.” Practice Location

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