Provider Demographics
NPI:1457517542
Name:FROELICH, JOY ANN (MD)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:ANN
Last Name:FROELICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S 2ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5729
Mailing Address - Country:US
Mailing Address - Phone:701-516-4637
Mailing Address - Fax:877-651-1381
Practice Address - Street 1:4535 NORTHERN SKY DRIVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503
Practice Address - Country:US
Practice Address - Phone:701-712-3000
Practice Address - Fax:701-712-3005
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND13026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1452055Medicaid
ND17540Medicaid
ND1452055Medicaid
ND17540Medicaid