STEPHEN J FRELLY PA

ADA WEST DERMATOLOGY, P.C.

Dr STEPHEN J FRELLY PA is a male medical professional, specializing in Physician Assistant. He graduated in 1997.

Contact

ADA WEST DERMATOLOGY, P.C.

1618 S MILLENNIUM WAY
SUITE 100
MERIDIAN
ID
836426457

Tel: 2088843376

STEPHEN J FRELLY PA Information

Npi 1114966959
Pac Id 9638144843
Professional Enrollment Id I20040831001301
Last Name FRELLY
First Name STEPHEN
Middle Name J
Suffix
Gender M
Credential PA
Medical School Name OTHER
Graduation Year 1997
Primary Specialty PHYSICIAN ASSISTANT
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name ADA WEST DERMATOLOGY, P.C.
Group Practice Pac Id 1153341532
Number Of Group Practice Members 15
Line 1 Street Address 1618 S MILLENNIUM WAY
Line 2 Street Address SUITE 100
Marker Of Address Line 2 Suppression
City MERIDIAN
State ID
Zip Code 836426457
Phone Number 2088843376
Hospital Affiliation Ccn 1 130007
Hospital Affiliation Lbn 1 SAINT ALPHONSUS REGIONAL MEDICAL CENTER
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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