Individual
DR. CALEB JAMES FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 GROVE RD, DEPT EMERGENCY MED, 4TH FLOOR SUPPORT TOWER, GREENVILLE, SC 29605
(864) 455-5198
Mailing address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-5198
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2023004726
MO
207P00000X
Emergency Medicine Physician
96769
SC
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
96769
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200085152
—
MO
Enumeration date
07/06/2020
Last updated
06/25/2026
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