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General NPI Number Information
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NPI Number | 1861548869
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Entity Type | Organization
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Legal Business Name | ROBERT D FRICKE MD
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 W LINCOLN ST STE 400
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City | BELLEVILLE
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State | IL
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Zip | 62220-1987
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Country | US
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Telephone | 618-234-5237
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W LINCOLN ST STE 400
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City | BELLEVILLE
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State | IL
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Zip | 62220-1987
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Country | US
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Telephone | 618-234-5237
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | ROBERT FRICKE
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Credential |
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Telephone | 618-234-5237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | IL
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