Basic Information
| Provider Information | |||||||||
| NPI: | 1497933063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREUNDEL | ||||||||
| FirstName: | ROSEANN | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 15TH ST NW | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242731627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766791623 | ||||||||
| FaxNumber: | 2766796811 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 15TH ST NW | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242731627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766791623 | ||||||||
| FaxNumber: | 2766796811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2008 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | OT011243 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VX0000X | DO2699 | ME | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | 207V00000X | H91026 | MD | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 0102202500 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1497933063 | 05 | VA | MEDICAID | P00920877 | 01 | RR MEDICARE | OTHER | 7100087150 | 05 | KY | MEDICAID |