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General NPI Number Information
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NPI Number | 1528052263
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Entity Type | Organization
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Legal Business Name | FREMONT FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1130 MAJOR AVE
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City | RIVERTON
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State | WY
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Zip | 82501-2342
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Country | US
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Telephone | 307-856-7800
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Fax | 307-857-7076
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Provider Business Mailing Address
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Address Line | 1130 MAJOR AVE
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City | RIVERTON
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State | WY
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Zip | 82501-2342
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Country | US
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Telephone | 307-856-7800
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Fax | 307-857-7076
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Authorized Official
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Title or Position | OWNER
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Name | DAVID JOSEPH STEGER
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Credential | M.D.
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Telephone | 307-856-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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