Individual
DR. NEIL WILLIAM FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1035 BELLEVUE AVE, 407, SAINT LOUIS, MO 63117-1854
(314) 645-1344
(314) 645-6457
Mailing address
1035 BELLEVUE AVE, 204, SAINT LOUIS, MO 63117-1854
(314) 645-1344
(314) 645-6457
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R8D71
MO
Other
Enumeration date
01/25/2007
Last updated
11/29/2016
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