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Individual

CHARLES E. FREDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3625 N ELM ST, SUITE 110A, GREENSBORO, NC 27455-2604
(336) 282-4840
(336) 282-4660
Mailing address
3625 N ELM ST, SUITE 110A, GREENSBORO, NC 27455-2604
(336) 282-4840
(336) 282-4660

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
26529
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33741
BCBS
NC
05
5764556
VA
05
8933741
NC
Enumeration date
05/15/2006
Last updated
03/15/2010
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