Basic Information
| Provider Information | |||||||||
| NPI: | 1396738597 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREI | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 CAMPUS DR | ||||||||
| Address2: | |||||||||
| City: | HANCOCK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 499301452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9064831700 | ||||||||
| FaxNumber: | 9063723230 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 CAMPUS DR | ||||||||
| Address2: | |||||||||
| City: | HANCOCK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 499301452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9064831700 | ||||||||
| FaxNumber: | 9063723230 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 02/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 5101010701 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3445961 | 05 | MI | MEDICAID | P00064002 | 01 | MI | RAILROAD MEDICARE | OTHER | JF010701 | 01 | MI | BCBS OF MICHIGAN | OTHER |