Individual
DR. DAPHNEY EDDY FREDERIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601
(757) 594-2000
(757) 826-9028
Mailing address
3998 FAIR RIDGE RD, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101249481
VA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
232133
MA
207R00000X
Internal Medicine Physician
232133
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134325400
—
VA
Enumeration date
06/25/2007
Last updated
10/03/2023
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