Provider Demographics
NPI:1912638602
Name:FRITEL, BRADY JAMES
Entity Type:Individual
Prefix:MR
First Name:BRADY
Middle Name:JAMES
Last Name:FRITEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 HOMESTEAD CT
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-4800
Mailing Address - Country:US
Mailing Address - Phone:701-200-2626
Mailing Address - Fax:
Practice Address - Street 1:780 HOMESTEAD CT
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-4800
Practice Address - Country:US
Practice Address - Phone:701-200-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator