Individual
ROSE E. FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 JOYCE ANNE DR, MANVILLE, RI 02838-1017
(401) 766-3334
Mailing address
15 JOYCE ANNE DR, MANVILLE, RI 02838-1017
(401) 766-3334
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
76629
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076629
TUFTS
—
01
—
28351
BMC HEALTHNET
—
05
—
3099750
—
MA
01
—
31041-9
BCBSRI
RI
01
—
413130
BLUE CHIP
—
01
—
AA47729
HPHC
—
01
—
B10071401
CIGNA
—
01
—
J13174
BCBSMA
MA
Enumeration date
03/13/2007
Last updated
07/08/2007
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