Provider Demographics
NPI:1225398621
Name:DAWES FRETZIN CLINICAL RESEARCH GROUP, LLC
Entity Type:Organization
Organization Name:DAWES FRETZIN CLINICAL RESEARCH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRETZIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-621-7790
Mailing Address - Street 1:8103 CLEARVISTA PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-5628
Mailing Address - Country:US
Mailing Address - Phone:317-621-7790
Mailing Address - Fax:317-621-7791
Practice Address - Street 1:8103 CLEARVISTA PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5628
Practice Address - Country:US
Practice Address - Phone:317-621-7790
Practice Address - Fax:317-621-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty