Provider Demographics
NPI:1215339668
Name:FRISCH WELCH, NATALIE LOUISE
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:LOUISE
Last Name:FRISCH WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15959 HALL ROAD
Mailing Address - Street 2:SUITE LL104
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044
Mailing Address - Country:US
Mailing Address - Phone:586-799-1212
Mailing Address - Fax:
Practice Address - Street 1:15959 HALL ROAD
Practice Address - Street 2:SUITE LL104
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5363
Practice Address - Country:US
Practice Address - Phone:586-799-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007158363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant