Individual
MRS. MARY L FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
731 POLO ROAD, COLUMBIA, SC 29223
(800) 491-0909
Mailing address
1624 MAIN ST, COLUMBIA, SC 29201-2818
(803) 726-2350
(803) 753-9102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20853
SC
Other
Enumeration date
03/15/2017
Last updated
08/14/2018
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