MEDICARE: RICHARD W. FRIESS 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	207Q00000X	Family Medicine Physician	0731	SD
2	207Q00000X	Family Medicine Physician	LL800	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346245164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD W. FRIESS MD

Provider Business Mailing Address
First Line	:	2355 STANFORD CT
Second Line	:	UNIT 701
City	:	NAPLES
State	:	FL
Zip	:	34112-4813
Country	:	US
Telephone Number	:	239-566-7425
Fax Number	:	239-593-3430

Provider Business Practice Location Address
First Line	:	2355 STANFORD CT
Second Line	:	UNIT 701
City	:	NAPLES
State	:	FL
Zip	:	34112-4813
Country	:	US
Telephone Number	:	239-566-7425
Fax Number	:	239-593-3430

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/27/2017

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Directions to “ RICHARD W. FRIESS MD” Practice Location

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