Organization
JEFFREY FREDERICK DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY FREDERICK D.P.M. (DOCTOR)
(248) 545-0100
Entity
Organization
Contact information
Practice address
30005 FOREST DR, FRANKLIN, MI 48025-1580
(248) 514-2604
Mailing address
27901 WOODWARD AVE, SUITE 110, BERKLEY, MI 48072-0919
(248) 545-0100
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
JF001355
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1746737
—
MI
01
—
480005115
MEDICARE RAILROAD
MI
01
—
4856354460
BLUE CROSS
MI
01
—
DG9358
MEDICARE RAILROAD GROUP
MI
Enumeration date
10/23/2006
Last updated
05/10/2023
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