Healthcare Provider Details

I. General information

NPI: 1710935838
Provider Name (Legal Business Name): TODD WILLIAM FRIEZE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 DUKE MEDICINE CIR
DURHAM NC
27710-4999
US

IV. Provider business mailing address

PO BOX 110566
DURHAM NC
27709-5566
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3600
  • Fax: 919-684-5743
Mailing address:
  • Phone: 919-620-4855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number11352803-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2022-03100
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: