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:
Health care specialties
| Specialty | Code | License # | 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 10 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 | 1578543260 | NPPES |
| Virginia | MEDICAID | 010176026 | |
| Virginia | Other | 180288 | |
| Virginia | MEDICAID | 200590450A | |
| Virginia | Other | 001746276 | |
| Virginia | MEDICAID | 3810002589 | |
| Virginia | Other | P00235877 |
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