MEDICARE: ROSEANN J FREUNDEL 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	207V00000X	Obstetrics & Gynecology Physician	OT011243	PA
2	207VX0000X	Obstetrics Physician	DO2699	ME
3	207V00000X	Obstetrics & Gynecology Physician	H91026	MD
4	207V00000X	Obstetrics & Gynecology Physician	0102202500	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00920877	OTHER		RR MEDICARE

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

General Provider Information

NPI Number	:	1497933063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEANN J FREUNDEL DO

Provider Business Mailing Address
First Line	:	102 15TH ST NW
Second Line	:	SUITE 301
City	:	NORTON
State	:	VA
Zip	:	24273-1627
Country	:	US
Telephone Number	:	276-679-1623
Fax Number	:	276-679-6811

Provider Business Practice Location Address
First Line	:	102 15TH ST NW
Second Line	:	SUITE 301
City	:	NORTON
State	:	VA
Zip	:	24273-1627
Country	:	US
Telephone Number	:	276-679-1623
Fax Number	:	276-679-6811

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

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	03/25/2021

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Directions to “ ROSEANN J FREUNDEL DO” Practice Location

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