Provider Demographics
NPI:1740556000
Name:FREW, WILLIAM CASEY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CASEY
Last Name:FREW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1101 MEDICAL CENTER BLVD.
Mailing Address - Street 2:ER
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-349-1533
Mailing Address - Fax:504-349-1530
Practice Address - Street 1:1101 MEDICAL CENTER BLVD.
Practice Address - Street 2:ER
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-1533
Practice Address - Fax:504-349-1530
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207465207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine