Basic Information
Provider Information
NPI: 1083998462
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRESCHOLTZ
FirstName: TOBY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1664 N VIRGINIA ST # MS -1332
Address2:  
City: RENO
State: NV
PostalCode: 895570001
CountryCode: US
TelephoneNumber: 7756828175
FaxNumber: 7753272009
Practice Location
Address1: 1664 N VIRGINIA ST # MS 153
Address2:  
City: RENO
State: NV
PostalCode: 895575241
CountryCode: US
TelephoneNumber: 7757844414
FaxNumber: 7756827902
Other Information
ProviderEnumerationDate: 10/04/2011
LastUpdateDate: 07/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X840847CAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X16125NVY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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