Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 44692 | MN |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 44692 | MN |
NPI | 1598727240 |
---|---|
Provider Name | David A Frenz |
First Address | Minneapolis, MN 55402-2606 |
Second Address | Minneapolis, MN 55402-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H73030 | (02) | MN |