Healthcare Provider Details

I. General information

NPI: 1902839376
Provider Name (Legal Business Name): JANET MARIE FRITSCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W 2ND ST
BLOOMINGTON IN
47403-2317
US

IV. Provider business mailing address

PO BOX 80
HARRODSBURG IN
47434-0080
US

V. Phone/Fax

Practice location:
  • Phone: 800-483-4804
  • Fax:
Mailing address:
  • Phone: 812-824-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01036666
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: