MEDICARE: DR. PETER PAUL FROHNERT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	19546	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19546	OTHER	MN	MINNESOTA BOARD OF MEDICAL PRACTICE

General Provider Information

NPI Number	:	1063650307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER PAUL FROHNERT MD

Provider Business Mailing Address
First Line	:	66 9TH ST E
Second Line	:	APT. 2305
City	:	SAINT PAUL
State	:	MN
Zip	:	55101-4700
Country	:	US
Telephone Number	:	651-291-0581
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 9TH ST E
Second Line	:	APT. 2305
City	:	SAINT PAUL
State	:	MN
Zip	:	55101-4700
Country	:	US
Telephone Number	:	651-291-0581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2009
Last Update Date	:	01/24/2009

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