Individual
DR. FREDRIC R MISHKIN
Active
Individual
DR. FREDRIC R MISHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD19796
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000053385
ANTHEM
KY
01
—
000127737
BCBS OF TN
TN
05
—
006025552
—
VA
01
—
057653
ANTHEM
VA
01
—
100010463
PHP TENNCARE
TN
05
—
1803461000
—
WV
05
—
3700033
—
TN
01
—
4675304
AETNA
TN
05
—
64794654
—
KY
01
—
TN0103
UNITED HEALTHCARE RIVER V
TN
Enumeration date
09/12/2005
Last updated
05/23/2008
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