Healthcare Provider Details
I. General information
NPI: 1043345887
Provider Name (Legal Business Name): SARAH M FRENNING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/22/2007
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
420 E 1ST ST
DULUTH MN
55805-1901
US
IV. Provider business mailing address
1702 UNIVERSITY DR S
FARGO ND
58103-4940
US
V. Phone/Fax
- Phone: 218-786-8364
- Fax:
- Phone: 701-364-4999
- Fax: 701-364-8476
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 19507 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: