# FRED G FEDOK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760449656
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | MD028333E | PA | — |
| 207YS0123X | Facial Plastic Surgery Physician | 15147 | AL | Yes |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 15147 | AL | — |

## Other

- **Enumeration date:** 04/26/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0011684000002 | — | PA |