Healthcare Provider Details

I. General information

NPI: 1164459509
Provider Name (Legal Business Name): FREMONT MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 N CLARKSON ST
FREMONT NE
68025-2312
US

IV. Provider business mailing address

2350 N CLARKSON ST
FREMONT NE
68025-2312
US

V. Phone/Fax

Practice location:
  • Phone: 402-721-6333
  • Fax: 402-721-6320
Mailing address:
  • Phone: 402-721-6333
  • Fax: 402-721-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN J DREYER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 402-721-6333