Individual
FRED MO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-8766
(202) 444-1655
Mailing address
PO BOX 418283, BOSTON, MA 02241-8283
(703) 558-1400
(703) 558-1445
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
0101251301
VA
207XS0117X
Orthopaedic Surgery of the Spine Physician
255689
NY
207XS0117X
Orthopaedic Surgery of the Spine Physician
MD042613
DC
Other
Enumeration date
11/28/2007
Last updated
01/09/2023
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