Individual
MR. FREDERICK T FEDOROWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 E LAFAYETTE BLVD, J426, DETROIT, MI 48226-2927
(313) 225-8173
(313) 225-0956
Mailing address
21 W NOBLE AVE, MONROE, MI 48162-2740
(734) 243-4344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001212
MI
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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