Individual
MR. FREDERICK R STARR
Active
Individual
MR. FREDERICK R STARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
200260016
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000522
—
OR
01
—
006401011
REGENCE BCBSO
OR
05
—
1023073426
—
ID
Enumeration date
04/19/2006
Last updated
09/27/2017
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