Physician Compare National (NPI:1649317413)

HEALTHCARE PROVIDER: DOUGLAS G. FREY PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1649317413
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123184553
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090310000036
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FREY
	Individual professional last name
Provider First Name	DOUGLAS
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7525 MITCHELL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 217
	Group Practice or individual's line 2 address
City	EDEN PRAIRIE
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	553441957
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y