MEDICARE: SEAN ALAN FRIEFELD DO

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	207P00000X	Emergency Medicine Physician	OS22811	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1467193243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN ALAN FRIEFELD DO

Provider Business Mailing Address
First Line	:	1601 CUMMINS DR STE D
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95358-6411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 TRINITY WAY
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-1155
Country	:	US
Telephone Number	:	904-450-8120
Fax Number	:

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	12/16/2025

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