Basic Information
Provider Information
NPI: 1649682097
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FREIHEIT
FirstName: DEREK
MiddleName: ROBERT
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1155 MILL ST # MSM14
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7759825262
FaxNumber: 7759823900
Practice Location
Address1: 1500 E 2ND ST STE 100
Address2:  
City: RENO
State: NV
PostalCode: 895021189
CountryCode: US
TelephoneNumber: 7759825003
FaxNumber: 7759825103
Other Information
ProviderEnumerationDate: 05/20/2014
LastUpdateDate: 02/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X19737NVN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X19737NVY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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