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Individual

FREDERICK CARL MAUTE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
927 S MAIN ST, DANVILLE, VA 24541-4001
(434) 797-4620
(434) 793-8992
Mailing address
927 S MAIN ST, DANVILLE, VA 24541-4001
(434) 797-4620
(434) 793-8992

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
0101039725
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051066
ANTHEM
VA
05
6241026
VA
Enumeration date
05/10/2006
Last updated
07/08/2007
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