Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 44437 | MN |
NPI | 1093744120 |
---|---|
Provider Name | Dr. Jerry Walter Froelich |
First Address | Minneapolis, MN 55455-0341 |
Second Address | Minneapolis, MN 55455-0356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0068000 | (05) | MT |
0571968 | (05) | IA |
1029764 | PREFERRED ONE (01) | MN |
10387 | (05) | ND |
16-02032 | MEDICA PRIMARY (01) | MN |
16-02745 | MEDICA CHOICE (01) | MN |
170259 | UCARE (01) | MN |
236323 | ARAZ (01) | MN |
7777470 | (05) | SD |
B49127 | (02) | MN |
HP34061 | HEALTHPARTNERS (01) | MN |