Individual
PIERRE G FREDERIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER BLVD, PROF. BLDG. 2 SUITE 422, CHESTER, PA 19013-3902
(610) 619-7460
Mailing address
1 MEDICAL CENTER BLVD, PROF. BLDG. 2 SUITE 422, CHESTER, PA 19013-3902
(610) 619-7460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD073166L
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD-073166L
PA
207RP1001X
Pulmonary Disease Physician
Primary
MD073166L
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD-073166L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011172990001
—
PA
Enumeration date
08/17/2006
Last updated
11/14/2011
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