# FRED W LAFFERTY MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851524540
- **Authorized official:** DR. FREDERIC W LAFFERTY M.D. (PRESIDENT)
- **Authorized official phone:** (216) 381-1142

## Contact information

- **Practice address:** 1611 S GREEN RD, SUITE 147, SOUTH EUCLID, OH 44121-4128
- **Practice address phone:** (216) 381-1142
- **Practice address fax:** (216) 381-6459
- **Mailing address:** 1611 S GREEN RD, SUITE 147, SOUTH EUCLID, OH 44121-4128
- **Mailing address phone:** (216) 381-1142
- **Mailing address fax:** (216) 381-6459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 23458 | OH | Yes |

## Other

- **Enumeration date:** 08/27/2009
- **Last updated:** 11/03/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0090584 | — | OH |