Provider Demographics
NPI:1962453464
Name:FRERICHS, R EVERETT (MD)
Entity Type:Individual
Prefix:DR
First Name:R
Middle Name:EVERETT
Last Name:FRERICHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 CARPATHIAN WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1612
Mailing Address - Country:US
Mailing Address - Phone:919-870-4449
Mailing Address - Fax:919-848-8238
Practice Address - Street 1:7205 STONEHENGE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1649
Practice Address - Country:US
Practice Address - Phone:919-848-2229
Practice Address - Fax:919-848-8238
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33241208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics