Provider Demographics
NPI:1609883750
Name:FRUENDT, MICHAEL DALE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DALE
Last Name:FRUENDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8210 STEPHANIE DR SW
Mailing Address - Street 2:STE A
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-3000
Mailing Address - Country:US
Mailing Address - Phone:256-213-9922
Mailing Address - Fax:256-213-9923
Practice Address - Street 1:3352 L & N DRIVE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5301
Practice Address - Country:US
Practice Address - Phone:256-213-9922
Practice Address - Fax:256-213-9923
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL089594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51504419FRUOtherBLUE CROSS BLUE SHIELD
AL7227274OtherAETNA
AL051504419Medicare ID - Type UnspecifiedMEDICARE
ALU87896Medicare UPIN