Individual
ROBERT M FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
513 BROOKWOOD BLVD, SUITE 50, BIRMINGHAM, AL 35209-6862
(205) 877-2761
(205) 877-2399
Mailing address
513 BROOKWOOD BLVD, SUITE 50, BIRMINGHAM, AL 35209-6862
(205) 877-2761
(205) 877-2399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14145
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110224928
MEDICARE RAILROAD
—
01
—
51503327
BLUE CROSS
AL
01
—
631266801 0041
CIGNA
—
05
—
9960800
—
AL
01
—
E46611
VIVA
—
Enumeration date
08/30/2006
Last updated
05/22/2008
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