Provider Demographics
NPI:1386673770
Name:FREY, JANET LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:LOUISE
Last Name:FREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:LOUISE
Other - Last Name:FOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4321 E TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-9219
Mailing Address - Country:US
Mailing Address - Phone:269-471-7036
Mailing Address - Fax:
Practice Address - Street 1:4321 E TUDOR RD
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-9219
Practice Address - Country:US
Practice Address - Phone:269-471-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301030525174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI300042960OtherRAILROAD MEDICARE
MI3101132152OtherBLUE CROSS
MI16-31136OtherPHP
MI2008027OtherCIGNA
MI4515448Medicaid
MI4515448Medicaid
MI2008027OtherCIGNA
MI3101132152OtherBLUE CROSS