MEDICARE: MR. MARK S FRIEZE PA

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	363A00000X	Physician Assistant	PA2914	FL
2	363A00000X	Physician Assistant	103004	NC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366417974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK S FRIEZE PA

Provider Business Mailing Address
First Line	:	1701 WESTCHESTER DR
Second Line	:	SUITE 850
City	:	HIGH POINT
State	:	NC
Zip	:	27262-7008
Country	:	US
Telephone Number	:	336-802-2145
Fax Number	:	336-802-2536

Provider Business Practice Location Address
First Line	:	1701 WESTCHESTER DR
Second Line	:	SUITE 850
City	:	HIGH POINT
State	:	NC
Zip	:	27262-7008
Country	:	US
Telephone Number	:	336-802-2145
Fax Number	:	336-802-2536

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

Provider Enumeration Date	:	02/18/2006
Last Update Date	:	09/11/2014

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Directions to “ MR. MARK S FRIEZE PA” Practice Location

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