Fredieu, Andre

Fredieu, Andre is an individual health care provider with primary practice located at 1245 S Utica Ave 3Rd Floor West, Tulsa OK 74104-4214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Fredieu, Andre can be contacted via phone (918) 560-3823.

Contact Information

Primary practice address
1245 S Utica Ave 3Rd Floor West Tulsa OK 74104-4214
Phone: (918) 560-3823
Fax: (918) 579-2535
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X P5364 Texas
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 31365 Oklahoma

Profile Details

NPI number 1578543260
LBN Legal business name Fredieu, Andre
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Aug 11th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578543260 NPPES
Virginia MEDICAID 010176026
Virginia Other 180288
Virginia MEDICAID 200590450A
Virginia Other 001746276
Virginia MEDICAID 3810002589
Virginia Other P00235877

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