Individual
ANTHONY CHARLES FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO MSC10 5550, ALBUQUERQUE, NM 87131-0001
(505) 272-4661
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD2023-0371
NM
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
MD2023-0371
NM
Other
Enumeration date
03/18/2019
Last updated
02/19/2025
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