Provider Demographics
NPI:1578576856
Name:FREHER, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:FREHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1841 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5117
Mailing Address - Country:US
Mailing Address - Phone:954-678-9531
Mailing Address - Fax:954-678-9533
Practice Address - Street 1:5258 LINTON BLVD STE 106
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6529
Practice Address - Country:US
Practice Address - Phone:561-303-3491
Practice Address - Fax:877-248-5240
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2019-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME83227207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL591975559OtherTAX ID
FL03207OtherBCBS
FL262400100Medicaid
FL060065771OtherMEDICARE RR
FL262400100Medicaid
FL03207XMedicare PIN
FL03207YMedicare PIN