Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 35084724 | OH |
NPI | 1033321567 |
---|---|
Provider Name | Richard Bruce Fries II |
First Address | Cincinnati, OH 45209-1957 |
Second Address | Cincinnati, OH 45209-1957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 10/12/2014 |