Provider Demographics
NPI:1144210444
Name:FRENN, ADEL E (MD)
Entity Type:Individual
Prefix:
First Name:ADEL
Middle Name:E
Last Name:FRENN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 EOFF ST
Mailing Address - Street 2:SUITE 601W
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3823
Mailing Address - Country:US
Mailing Address - Phone:304-234-8702
Mailing Address - Fax:304-234-8736
Practice Address - Street 1:2000 EOFF ST
Practice Address - Street 2:SUITE 601W
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3823
Practice Address - Country:US
Practice Address - Phone:304-234-8702
Practice Address - Fax:304-234-8736
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17914207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0086141000Medicaid
OH985895Medicaid
F96132Medicare UPIN
WVFR0766592Medicare PIN