Individual
MR. FRED HIGGINS
Active
Individual
MR. FRED HIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200277370
—
IN
01
—
352101814
TAX ID#
IN
Enumeration date
10/18/2006
Last updated
08/27/2008
Update your record
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