MEDICARE: ANDREA MARIE FRITSCHLE M.D.

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	2084P0800X	Psychiatry Physician	28886	SC
2	2084P0800X	Psychiatry Physician	065967	GA
3	2084P0800X	Psychiatry Physician	LL28886	SC
4	2084P0800X	Psychiatry Physician	ME113805	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	:	1942386032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MARIE FRITSCHLE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 208
Second Line	:
City	:	LELAND
State	:	NC
Zip	:	28451-0208
Country	:	US
Telephone Number	:	703-766-6555
Fax Number	:	800-731-6158

Provider Business Practice Location Address
First Line	:	670 PLACERVILLE DR STE 2
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-4200
Country	:	US
Telephone Number	:	530-644-2412
Fax Number	:

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	09/27/2022

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