Provider Demographics
NPI:1013675594
Name:MATTHEW FRIEDERICHS MD PLLC
Entity Type:Organization
Organization Name:MATTHEW FRIEDERICHS MD PLLC
Other - Org Name:ORTHODAKOTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNERS
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDERICHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-707-0200
Mailing Address - Street 1:2829 UNIVERSITY DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6050
Mailing Address - Country:US
Mailing Address - Phone:701-707-0200
Mailing Address - Fax:
Practice Address - Street 1:2829 UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6050
Practice Address - Country:US
Practice Address - Phone:701-707-0200
Practice Address - Fax:701-707-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty