Fredstrom, David A.
Fredstrom, David A. is an individual health care provider with primary practice located at 1247 Ne Medical Center Dr C, Bend OR 97701-3786. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fredstrom, David A. can be contacted via phone (541) 318-4249.Contact Information
Primary practice address
1247 Ne Medical Center Dr C
Bend OR 97701-3786
Phone: (541) 318-4249
Fax: (541) 312-5230
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD08366 | Oregon |
Profile Details
| NPI number | 1285614792 |
|---|---|
| LBN Legal business name | Fredstrom, David A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2006 |
| Last updated | Jul 12th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285614792 | NPPES |
| Oregon | MEDICAID | 063347 |
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