Provider Demographics
NPI:1801996285
Name:MENZER, FRIEDA M (MD)
Entity type:Individual
Prefix:
First Name:FRIEDA
Middle Name:M
Last Name:MENZER
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 1:3608 MEDICAL PARK CT
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4347
Mailing Address - Country:US
Mailing Address - Phone:252-247-3476
Mailing Address - Fax:252-247-3478
Practice Address - Street 1:3608 MEDICAL PARK CT
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4347
Practice Address - Country:US
Practice Address - Phone:252-247-3476
Practice Address - Fax:252-247-3478
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC297836OtherMAMSI
NC12422OtherBCBS OF NC
NC400579OtherUHC
NCB1066OtherMEDCOST
NC8912422Medicaid
NC31904OtherPARTNERS
H04356Medicare UPIN
NC110227615Medicare ID - Type UnspecifiedRR MEDICARE
NC2279783AMedicare ID - Type UnspecifiedMEDICARE